Hafnarstræti 21, 600 Akureyri, ground floor of a two-story commercial building. Constructed in 1965, reinforced concrete. Main entrance is street-level with double glass doors. No elevator. No security features. Street parking available. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6810° N, 18.0915° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm, shortness of breath, diaphoresis. Patient reports feeling lightheaded and nauseous. Skin pale and clammy. Patient is sitting on a chair in his office. Medical history: Hypertension, hyperlipidemia, type 2 diabetes. Medications: Metformin 1000mg BID, Atorvastatin 20mg daily, Lisinopril 20mg daily. No known allergies. Last meal was a sandwich around 12:00.
Timeline: 1330 hours: Patient started experiencing mild chest discomfort while working at his desk. 1340 hours: Chest pain intensified, radiating to left arm. Patient became short of breath and sweaty. 1345 hours: Patient felt lightheaded and nauseous, called his coworker for help. 1348 hours: Coworker called emergency services. 1350 hours: Current time, patient is conscious but in significant distress. Prior Events: Patient has had no prior history of chest pain. Recent stress due to work deadlines. Last check-up was 6 months ago, routine follow-up. Patient reports occasional palpitations but no prior cardiac events. No recent illnesses or injuries.
Initial Impression: Suspected Acute Myocardial Infarction (AMI) Justification for F2 Classification: - High probability of a cardiac event based on symptoms: chest pain, radiation, shortness of breath, diaphoresis. - Time-sensitive condition requiring prompt medical intervention to minimize myocardial damage. - Patient has multiple risk factors for coronary artery disease. Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (less likely, given severity of pain and associated symptoms) 3. Aortic Dissection (less likely, given lack of tearing pain and specific risk factors) 4. Pulmonary Embolism (less likely, given lack of sudden onset and pleuritic pain) Required Actions: - Dispatch of ground EMS with ALS capabilities. - Immediate ECG acquisition and transmission. - Oxygen administration and cardiac monitoring. - Preparation for transport to nearest hospital with cardiac catheterization lab.