Hafnarstræti 18, 600 Akureyri, first floor, commercial space. Two-story building of mixed concrete and wood construction, built in 1955. Main entrance faces the street, with a secondary back entrance used for deliveries. No elevator. Street parking available. The building has basic security locks. Current weather conditions: 8°C, overcast, light wind, good visibility. GPS coordinates: 65.6812° N, 18.0914° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing sudden onset chest pain at his workplace. Primary symptoms: Severe, crushing chest pain radiating to the left arm, shortness of breath, diaphoresis. Secondary symptoms: Nausea, dizziness. Patient is conscious but appears anxious. Skin is pale and clammy. Patient is sitting on a chair in the office area. Medical history: Hypertension, hypercholesterolemia. Medications: Lisinopril 10mg daily, Atorvastatin 20mg daily. No known allergies. Last meal was lunch at 12:00, a sandwich and coffee.
Timeline: 1410 hours: Patient began experiencing mild chest discomfort. 1415 hours: Chest pain intensified, radiating to left arm, accompanied by shortness of breath. 1418 hours: Patient became diaphoretic and nauseous. 1420 hours: Patient sat down, feeling dizzy. Co-worker called emergency services. 1422 hours: Current time, patient is conscious but in distress. Prior Events: Patient reports occasional mild chest discomfort over the past few weeks, attributed to indigestion. No prior cardiac events or hospitalizations. Last medical check-up 6 months ago, routine follow-up. Patient is a non-smoker and reports moderate alcohol consumption on weekends.
Initial Impression: Suspected Acute Coronary Syndrome (ACS) / Myocardial Infarction Justification for F2 Classification: - High probability of a cardiac event based on classic presentation of chest pain, radiation, and associated symptoms - Time-sensitive condition requiring rapid medical intervention to minimize myocardial damage - Patient's risk factors (age, hypertension, hypercholesterolemia) increase the likelihood of ACS Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (likely) 3. Aortic Dissection (less likely given no tearing pain) 4. Pulmonary Embolism (less likely given no sudden onset of severe dyspnea) 5. Musculoskeletal Chest Pain (less likely given severity and radiation) Required Actions: - Dispatch of ground EMS with ALS capabilities - Initiate cardiac monitoring and ECG - Administer oxygen and aspirin if not contraindicated - Prepare for immediate transport to nearest hospital with cardiac catheterization lab