Hafnarstræti 21, 600 Akureyri, third floor office, suite 305. A five-story reinforced concrete commercial building constructed in 1995. Main entrance has a keypad access after hours. Two elevators and a central stairwell. Street parking available. Building is equipped with a sprinkler system. Current conditions: 7°C, overcast, moderate visibility. GPS coordinates: 65.6812° N, 18.0914° W. Nearest landmark: Hof Cultural and Conference Center.
52-year-old male, experiencing sudden onset chest pain. Primary symptoms: Severe, crushing chest pain radiating to the 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 in his office chair. Medical history: Hypertension, hypercholesterolemia, smoker (1 pack per day for 30 years). Medications: Lisinopril 20mg daily, Atorvastatin 40mg daily. No known allergies. Last meal was a sandwich at 12:00.
Timeline: 1345 hours: Patient reports feeling mild discomfort in his chest 1350 hours: Pain intensifies rapidly, becomes severe, radiating to left arm and jaw 1352 hours: Patient becomes diaphoretic, short of breath, feels nauseous 1354 hours: Patient calls his colleague for help, who then calls emergency services 1356 hours: Current time, patient is still in his office chair, experiencing chest pain Prior Events: Patient reports occasional mild chest discomfort in the past few weeks, attributed to indigestion. No prior history of heart attack or angina. Last medical check-up 6 months ago, routine follow-up. Patient works as an accountant.
Initial Impression: Suspected Acute Coronary Syndrome (ACS), likely Myocardial Infarction Justification for F2 Classification: - High probability of a life-threatening cardiac event based on symptoms - Severe chest pain, radiating to left arm and jaw, diaphoresis, shortness of breath - Time-sensitive condition requiring immediate medical intervention Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (likely, needs urgent evaluation) 3. Aortic Dissection (less likely, no tearing pain reported) 4. Pulmonary Embolism (less likely, no sudden pleuritic chest pain reported) 5. Musculoskeletal Chest Pain (less likely given severity and radiation) Required Actions: - Dispatch of ground EMS with ALS capabilities - ECG monitoring and interpretation - Oxygen administration - Aspirin administration - Preparation for transport to nearest hospital with cardiac catheterization capabilities