Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. Five-story concrete building constructed in 1968. Main entrance has a coded lock, code is 1945. There is one elevator and a central stairwell. Street parking is available. Building has a fire alarm system. Current conditions: 8°C, overcast, moderate visibility. GPS coordinates: 65.6821° N, 18.0933° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm, shortness of breath, diaphoresis. Patient reports feeling lightheaded. Patient is conscious but anxious. Skin is pale and clammy. Patient is sitting on a chair in his living room. Medical history: Hypertension, type 2 diabetes, hyperlipidemia. Medications: Metformin 500mg twice daily, Atorvastatin 20mg daily, Lisinopril 10mg daily, Aspirin 75mg daily. Known allergy to penicillin. Last meal was a light lunch at 13:00.
Timeline: 1415 hours: Patient started experiencing mild chest discomfort while watching television. 1420 hours: Chest pain intensified, radiating to left arm, patient became diaphoretic and short of breath. 1425 hours: Patient felt lightheaded and called his son for help. 1428 hours: Son arrived, called emergency services. 1430 hours: Current time, patient still experiencing severe chest pain. Prior Events: Patient had a similar episode of chest pain two months ago, was evaluated in the ER, and discharged with a diagnosis of stable angina. No prior heart attack. Last medical check-up 6 months ago, routine follow-up. Patient lives alone, son lives nearby.
Initial Impression: Suspected Acute Coronary Syndrome (ACS), likely Myocardial Infarction (MI) Justification for F2 Classification: - High probability of cardiac event based on classic symptoms (crushing chest pain, radiation, diaphoresis, shortness of breath) - Patient has risk factors for ACS (hypertension, diabetes, hyperlipidemia) - Time-sensitive condition requiring prompt medical intervention to minimize myocardial damage Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (high probability) 3. Aortic Dissection (less likely, no reported tearing pain) 4. Pulmonary Embolism (less likely, no pleuritic pain or hemoptysis) 5. Musculoskeletal chest pain (less likely, pain is severe and radiating) Required Actions: - Dispatch of ground EMS with ALS capabilities - ECG monitoring and interpretation - Oxygen administration - Aspirin administration (if not already taken) - Rapid transport to nearest hospital with cardiac catheterization lab