Hafnarstræti 18, 600 Akureyri, ground floor, commercial building, former bookstore, now a small office space. Single-story concrete building, built in 1950. Main entrance is street-level with a single door, no steps. No elevator. Street parking available. Building has basic fire alarm system. Current conditions: 7°C, overcast, light breeze. GPS coordinates: 65.6810° N, 18.0912° W. Nearest landmark: Akureyri Art Museum.
55-year-old male, experiencing sudden onset of severe chest pain. Primary symptoms: Retrosternal chest pain, described as crushing, radiating to left arm and jaw, shortness of breath, diaphoresis. Patient is pale and anxious. Secondary symptoms: Nausea, dizziness. Patient is conscious but distressed. Medical history: Hypertension, hyperlipidemia, smoker (20 pack-years). Medications: Amlodipine 10mg daily, Atorvastatin 40mg daily. No known allergies. Last meal was a sandwich at 12:00.
Timeline: 1315 hours: Patient started experiencing mild chest discomfort 1320 hours: Chest pain increased in intensity, became crushing, radiating to left arm and jaw 1322 hours: Patient began experiencing shortness of breath and sweating 1325 hours: Patient called emergency services, current time. Patient is seated in an office chair, holding his chest. Prior Events: Patient reports experiencing similar episodes of mild chest discomfort in the past month, attributed to indigestion. No prior cardiac events. Last medical check-up 6 months ago, routine follow-up. Patient was at work when symptoms began.
Initial Impression: Suspected Acute Coronary Syndrome (ACS), likely Myocardial Infarction Justification for F2 Classification: - High probability of a life-threatening cardiac event based on symptoms (crushing chest pain, radiation, diaphoresis) - Time-sensitive condition requiring immediate medical intervention - Patient at risk of sudden cardiac arrest Differential Diagnoses: 1. Myocardial Infarction (high probability) 2. Unstable Angina (likely, cannot rule out MI) 3. Aortic Dissection (less likely, no tearing pain reported) 4. Pulmonary Embolism (less likely, no sudden onset of dyspnea without chest pain) 5. Esophageal Spasm (less likely, pain is not typically crushing and radiating) Required Actions: - Dispatch of ground EMS with ALS capabilities - ECG monitoring and analysis - Oxygen administration - Aspirin administration - Rapid transport to nearest hospital with cardiac catheterization lab