Hafnarstræti 23, 600 Akureyri, third floor office 3B. A three-story brick building, built in 1965, with a main entrance on Hafnarstræti. One elevator and central stairwell. Street parking available. Building has a basic fire alarm system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6821° N, 18.0901° W. Nearest landmark: Akureyri Art Museum.
56-year-old male, experiencing sudden onset of severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm and jaw, shortness of breath, diaphoresis. Secondary symptoms: Nausea, dizziness. Patient is conscious but anxious. Skin pale and clammy. Patient is sitting at his desk in the office. Medical history: Hypertension diagnosed 5 years ago, hyperlipidemia. Medications: Lisinopril 10mg daily, Atorvastatin 20mg daily. No known allergies. Last meal was a sandwich at 12:00.
Timeline: 1315 hours: Patient reports sudden onset of severe chest pain while working at his desk 1316 hours: Pain radiates to left arm and jaw, patient becomes diaphoretic 1317 hours: Patient reports shortness of breath and nausea 1318 hours: Patient calls his colleague for help 1320 hours: Colleague calls emergency services 1322 hours: Current time, patient is still at his desk, pale and anxious Prior Events: Patient reports occasional episodes of mild chest discomfort over the past few months, which he 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, generally sedentary lifestyle.
Initial Impression: Suspected Acute Myocardial Infarction (AMI) Justification for F2 Classification: - High probability of a serious cardiac event based on classic symptoms - Time-sensitive condition requiring prompt intervention to minimize myocardial damage - Patient reports severe chest pain, radiating pain, diaphoresis, and shortness of breath Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Angina Pectoris (less likely given severity and sudden onset) 3. Aortic Dissection (less likely, no reported tearing pain) 4. Pulmonary Embolism (less likely, no risk factors or prior history) 5. Esophageal Spasm (less likely, pain is severe and radiating) Required Actions: - Dispatch of ground EMS with ALS capabilities - Initiate oxygen therapy and ECG monitoring - Preparation for transport to nearest hospital with cardiac catheterization lab