Hafnarstræti 23, 600 Akureyri, ground floor, retail shop. One-story concrete building, built in 1965, with a large glass storefront. Main entrance is directly from the street. No security features. Street parking available. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6810° N, 18.0900° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing sudden onset of severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm, shortness of breath, diaphoresis. Patient reports feeling anxious and lightheaded. Patient is sitting on a chair in the shop. Medical history: Hypertension, hypercholesterolemia, smoker. Medications: Lisinopril 10mg daily, Atorvastatin 20mg daily, Aspirin 75mg daily. No known allergies. Last meal was a sandwich at 13:00.
Timeline: 1415 hours: Patient felt sudden onset of chest pain while working in the shop 1416 hours: Pain intensified, radiating to left arm, shortness of breath started 1417 hours: Patient became diaphoretic and lightheaded 1418 hours: Patient called emergency services 1420 hours: Current time, patient sitting in chair, waiting for help Prior Events: Patient reports occasional mild chest discomfort for the past few weeks, attributed to indigestion. No recent illnesses or injuries. Last medical check-up 6 months ago, routine follow-up. Patient works alone in the shop.
Initial Impression: Suspected Acute Coronary Syndrome (ACS) Justification for F2 Classification: - High probability of a life-threatening cardiac event based on symptoms and risk factors - Severe chest pain, radiation to left arm, diaphoresis, shortness of breath - Time-sensitive condition requiring prompt medical evaluation and intervention Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (high probability) 3. Aortic Dissection (less likely given presentation) 4. Pulmonary Embolism (less likely given presentation) 5. Musculoskeletal Chest Pain (less likely given severity and radiation) Required Actions: - Dispatch of ground EMS with ALS capabilities - Immediate ECG acquisition and interpretation - Oxygen therapy administration - Preparation for transport to nearest hospital with cardiac catheterization lab