Hafnarstræti 18, 600 Akureyri. Ground floor of a two-story commercial building, built in 1965. Main entrance is street-level with a single glass door. No elevators. Limited parking on the street. Building has a basic security system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6823° N, 18.0889° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm, shortness of breath, diaphoresis. Secondary symptoms: Nausea, dizziness. Patient alert but anxious. Skin pale and clammy. Patient is sitting on a chair in his office. Medical history: Hypertension, hypercholesterolemia, type 2 diabetes. Medications: Metformin 500mg twice daily, Atorvastatin 20mg daily, Lisinopril 10mg daily. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 1430 hours: Patient started experiencing mild chest discomfort 1440 hours: Chest pain increased in intensity, radiating to left arm 1445 hours: Patient became diaphoretic and short of breath 1448 hours: Patient called emergency services 1450 hours: Current time, patient still experiencing severe chest pain Prior Events: Patient has a history of controlled hypertension, hypercholesterolemia, and type 2 diabetes. No prior history of heart attack. Last medical check-up 6 months ago, routine follow-up. No recent illnesses or injuries. Patient was at work when symptoms began.
Initial Impression: Suspected Acute Myocardial Infarction (AMI) Justification for F2 Classification: - High probability of a time-sensitive, life-threatening cardiac event - Patient presenting with classic AMI symptoms: severe chest pain, radiation, diaphoresis, shortness of breath - Requires immediate medical intervention to minimize myocardial damage Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Angina Pectoris (less likely given severity of pain and diaphoresis) 3. Aortic Dissection (less likely given absence of tearing pain) 4. Pulmonary Embolism (less likely given absence of pleuritic pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - Immediate ECG acquisition and interpretation - Oxygen administration and IV access - Aspirin administration (if not contraindicated) - Notification of receiving hospital for potential PCI