Hafnarstræti 18, 600 Akureyri, second floor, apartment 202. Three-story mixed-use building, built in 1965, with commercial spaces on the ground floor and residential apartments above. The main entrance is on Hafnarstræti, accessible via a coded door (code: 1965). There is a central staircase, no elevator. Street parking is available. The building has a basic fire alarm system. Current weather conditions: 7°C, overcast, light wind, good visibility. GPS coordinates: 65.6835° N, 18.0896° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm and jaw, shortness of breath, diaphoresis. Patient reports onset of pain 20 minutes ago. Secondary symptoms: Nausea, dizziness. Patient is conscious and anxious. Skin is pale and clammy. Patient is sitting on a chair in the living room. Medical history: Hypertension, hyperlipidemia, Type 2 diabetes. Medications: Metformin 1000mg twice daily, Atorvastatin 20mg daily, Lisinopril 20mg daily. Known allergy to penicillin. Last meal was a light lunch at 13:00.
Timeline: 1415 hours: Patient began experiencing mild chest discomfort while watching TV. 1420 hours: Chest pain intensified, radiating to left arm and jaw, accompanied by shortness of breath and sweating. 1425 hours: Patient became increasingly anxious and called his son, who is now calling emergency services. 1430 hours: Current time, patient is sitting in a chair, experiencing severe chest pain, and is pale and sweaty. Prior Events: Patient has a history of stable angina for the past 2 years, managed with medications. No recent hospitalizations or significant health events. Last check-up was 6 months ago, routine follow-up. Patient lives with his wife, who is present but very distressed.
Initial Impression: Suspected Acute Myocardial Infarction (AMI) Justification for F2 Classification: - High probability of a time-sensitive, life-threatening condition based on symptom presentation - Severe chest pain, radiating to left arm and jaw, associated with shortness of breath and diaphoresis - Presence of risk factors such as hypertension, hyperlipidemia, and diabetes - Requires rapid assessment and intervention to minimize myocardial damage Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (less likely, given severity and duration of symptoms) 3. Aortic Dissection (lower probability, no reported back pain) 4. Pulmonary Embolism (lower probability, no reported pleuritic pain) 5. Panic Attack (less likely given the physical symptoms and medical history) Required Actions: - Dispatch of ground EMS with ALS capabilities - Initiate cardiac monitoring and oxygen therapy - Preparation for transport to nearest hospital with cardiac catheterization capabilities - Pre-hospital notification of cardiac team