Hafnarstræti 18, 600 Akureyri, first floor of a two-story wooden building, constructed in 1945, with a single main entrance facing the street. Street parking available, no elevator. Building is equipped with a basic fire alarm system. Current conditions: 7°C, overcast, moderate visibility. GPS coordinates: 65.6827° N, 18.0922° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe chest pain, onset 20 minutes ago. Primary symptoms: Substernal chest pain described as crushing, radiating to the left arm and jaw, shortness of breath, diaphoresis, nausea. Secondary symptoms: Lightheadedness, anxiety. Patient is alert but distressed. Skin is pale and clammy. Patient is sitting in a chair in his office. Medical history: Hypertension, hyperlipidemia, type 2 diabetes. Medications: Metformin 500mg twice daily, Atorvastatin 20mg daily, Lisinopril 10mg daily. No known allergies. Last meal was a light lunch at 12:00.
Timeline: 1315 hours: Patient began experiencing mild chest discomfort while working at his desk. 1320 hours: Chest pain intensified, became severe, radiating to left arm and jaw. Patient began experiencing shortness of breath and diaphoresis. 1325 hours: Patient felt lightheaded and nauseous. Patient called his son for help. 1328 hours: Son arrived and called emergency services. 1330 hours: Current time, patient still sitting in chair, experiencing severe chest pain. Prior Events: Patient reports occasional mild chest discomfort during exertion, but never this severe. No recent illnesses or injuries. Last medical check-up 6 months ago, routine follow-up. Patient lives with his wife, son lives nearby.
Initial Impression: Suspected Acute Coronary Syndrome (ACS) Justification for F2 Classification: - High probability of significant cardiac event based on presentation - Severe chest pain with radiation, shortness of breath, diaphoresis - Time-sensitive condition requiring prompt medical evaluation and intervention Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (less likely given severity and duration) 3. Aortic Dissection (less likely, no reported tearing pain) 4. Pulmonary Embolism (less likely, no history of DVT or recent surgery) Required Actions: - Dispatch of ground EMS with ALS capabilities - ECG monitoring and interpretation - Oxygen administration if indicated - Aspirin administration if not contraindicated - Preparation for transport to nearest hospital with cardiac catheterization capabilities