Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. A four-story mixed-use building, built in 1965, with commercial spaces on the ground floor and residential units above. Main entrance on Hafnarstræti, accessible via a shared hallway and stairwell. No elevator. Street parking available, often limited. Building has a fire alarm system. Current conditions: 7°C, overcast, moderate visibility. GPS coordinates: 65.6819° N, 18.0915° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe chest pain. Primary symptoms: Sudden onset of crushing chest pain, radiating to left arm and jaw, shortness of breath, diaphoresis. Secondary symptoms: Nausea, dizziness. Patient is conscious but anxious. Skin is pale and clammy. Patient is sitting on a chair in his living room. Medical history: Hypertension, hyperlipidemia, type 2 diabetes. Medications: Metformin 1000mg twice daily, Atorvastatin 20mg daily, Lisinopril 10mg daily. Known allergy to penicillin. Last meal was a sandwich at 11:00.
Timeline: 1210 hours: Patient was watching TV, sudden onset of chest pain 1212 hours: Patient reports pain radiating to left arm and jaw, shortness of breath 1214 hours: Patient feels nauseous, diaphoretic 1215 hours: Patient called emergency services 1217 hours: Current time, patient sitting on chair, still experiencing chest pain Prior Events: Patient has a history of poorly controlled hypertension and hyperlipidemia. Patient reports similar but less severe episodes of chest discomfort in the past year. Last medical check-up was 6 months ago, routine follow-up. Patient lives alone.
Initial Impression: Suspected Acute Coronary Syndrome (ACS) - likely Myocardial Infarction Justification for F2 Classification: - High probability of life-threatening cardiac event based on classic ACS symptoms - Severe chest pain, radiating pain, shortness of breath, diaphoresis - Time-sensitive condition requiring prompt medical evaluation and treatment Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (likely) 3. Aortic Dissection (less likely given no reported back pain) 4. Pulmonary Embolism (less likely given presentation) 5. Gastroesophageal Reflux (less likely given severity and radiating pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - ECG monitoring and interpretation - Oxygen administration - Aspirin administration (if no contraindications) - Preparation for transport to nearest hospital with cardiac services