Hafnarstræti 18, 600 Akureyri, first floor. A two-story wooden building built in 1935. Main entrance is street level, no elevator. Street parking is available. The building has a basic fire alarm system. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6828° N, 18.0938° W. Nearest landmark: Akureyri Art Museum.
68-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. Patient reports feeling dizzy and nauseous. Secondary symptoms: Palpitations, feeling of impending doom. Patient is conscious but anxious. Skin is pale and clammy. Patient is sitting on a chair in his office. Medical history: Type 2 diabetes, hypertension, hyperlipidemia. Medications: Metformin 1000mg twice daily, Lisinopril 20mg daily, Atorvastatin 40mg daily. Known allergy to penicillin. Last meal was a light lunch at 12:00.
Timeline: 13:15 hours: Patient began experiencing mild chest discomfort 13:20 hours: Chest pain became severe, radiating to left arm and jaw 13:22 hours: Patient became diaphoretic, felt dizzy and nauseous 13:25 hours: Patient called emergency services 13:27 hours: Current time, patient still experiencing severe chest pain Prior Events: Patient reports occasional mild chest discomfort for the past few weeks, which he attributed to indigestion. No prior history of heart attack or angina. Last medical check-up 6 months ago, routine follow-up. Patient lives alone, but his son lives nearby.
Initial Impression: Suspected Acute Coronary Syndrome (ACS) Justification for F2 Classification: - Severe chest pain with classic ACS symptoms (radiation, diaphoresis, nausea) - High risk factors (diabetes, hypertension, hyperlipidemia) - Time-sensitive condition requiring prompt medical evaluation and treatment 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 reported pleuritic pain or recent surgery) Required Actions: - Dispatch of ground EMS with ALS capabilities - ECG monitoring and acquisition - Oxygen administration - Aspirin administration (if no contraindications) - Preparation for transport to nearest hospital with cardiac catheterization lab