Hafnarstræti 22, 600 Akureyri. Second floor of a three-story commercial building, built in 1965. Main entrance is street level, with a secondary entrance in the back via a narrow alley. No elevator, only a central staircase. Building is equipped with a basic fire alarm. Current conditions: 7°C, overcast, light wind, good visibility. GPS coordinates: 65.6819° N, 18.0913° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing sudden onset of severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm and jaw, shortness of breath, diaphoresis. Patient reports feeling lightheaded. Secondary symptoms: Nausea, anxiety. Patient is conscious but distressed. 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: 1230 hours: Patient began experiencing mild chest discomfort while walking to his office. 1235 hours: Chest pain intensified, radiating to left arm and jaw, onset of shortness of breath and diaphoresis. 1238 hours: Patient felt lightheaded and sat down, called his son for help. 1240 hours: Son arrived and called emergency services. 1242 hours: Current time, patient is sitting on a chair in his office, pale and diaphoretic. Prior Events: Patient had a similar episode of chest pain 6 months ago, was evaluated at the local clinic, and diagnosed with stable angina. No recent changes in medication. No recent illnesses or injuries. Last medical check-up 2 months ago, routine follow-up. Patient works as an accountant, lives with his wife.
Initial Impression: Suspected Acute Coronary Syndrome (ACS), likely Myocardial Infarction (MI) Justification for F2 Classification: - High probability of a life-threatening cardiac event based on presenting symptoms - Severe chest pain, radiation, shortness of breath, diaphoresis - Time-sensitive condition requiring immediate medical intervention to limit 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 risk factors) 5. Pericarditis (less likely, no fever or pleuritic pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - ECG monitoring and analysis - Oxygen administration - Pain management and antiplatelet medication initiation - Preparation for immediate transport to nearest hospital with cardiac catheterization capabilities