Hafnarstræti 18, 600 Akureyri, Ground floor of a commercial building. Built in 1965, concrete construction. Main entrance is street level with a glass door. No elevators. Street parking available. No security features. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6813° N, 18.0910° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm and jaw, shortness of breath, diaphoresis. Patient reports feeling lightheaded and nauseous. Patient is conscious and speaking, but appears distressed. Skin is pale and clammy. Medical history: Hypertension, hypercholesterolemia, type 2 diabetes. Medications: Metformin 1000mg twice daily, Atorvastatin 20mg daily, Lisinopril 10mg daily. Known allergy to penicillin. Last meal was a sandwich at 11:00.
Timeline: 1215 hours: Patient started experiencing mild chest discomfort while walking 1220 hours: Chest pain increased in intensity and began radiating to left arm and jaw 1222 hours: Patient became short of breath and started sweating 1225 hours: Patient called emergency services, now feeling nauseous and lightheaded Prior Events: Patient had similar episodes of chest discomfort in the past, but less severe. Last medical check-up 6 months ago, routine follow-up. Patient is a smoker with a history of 30 pack-years. No recent illnesses or injuries. Patient was at his office when symptoms started.
Initial Impression: Suspected Acute Myocardial Infarction (AMI) Justification for F2 Classification: - High probability of a cardiac event based on classic symptoms - Chest pain radiating to left arm and jaw, diaphoresis, and shortness of breath - Time-sensitive condition requiring immediate medical intervention to minimize myocardial damage Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (less likely given severity and radiation of pain) 3. Aortic Dissection (less likely given lack of tearing pain) 4. Pulmonary Embolism (lower probability given lack of risk factors and presentation) Required Actions: - Dispatch of ground EMS with ALS capabilities - ECG acquisition and interpretation - Oxygen administration - Aspirin administration (if no contraindications) - Preparation for transport to nearest hospital with cardiac catheterization lab