Hafnarstræti 22, 600 Akureyri, ground floor of a two-story wooden building, built in 1955, with a single main entrance at street level. No elevator, internal stairs to second floor. Street parking available. Building has basic security with a standard door lock. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6828° N, 18.0914° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe chest pain, onset 20 minutes ago. Primary symptoms: Crushing chest pain radiating to left arm and jaw, shortness of breath, diaphoresis. Patient is pale, anxious, and reports feeling lightheaded. Secondary symptoms: Nausea, mild dizziness. Patient is sitting upright in a chair. Medical history: Hypertension, hyperlipidemia, Type 2 Diabetes, previous myocardial infarction 5 years ago. Medications: Metformin 1000mg twice daily, Atorvastatin 40mg daily, Ramipril 5mg daily, Aspirin 75mg daily, Metoprolol 50mg twice daily. Known allergy to penicillin. Last meal was a light lunch at 12:00.
Timeline: 1315 hours: Patient experienced sudden onset of severe chest pain while watching television. 1316 hours: Pain intensified, radiating to left arm and jaw, shortness of breath developed. 1318 hours: Patient became diaphoretic, felt lightheaded and nauseous. 1320 hours: Patient called emergency services. Current time, patient is sitting upright in a chair, pale, anxious, and short of breath. Prior Events: Patient has a history of previous myocardial infarction, managed with medication. Recent check-up 2 months ago, stable condition reported. Patient reports no recent changes in medication or activity levels. No recent illnesses or injuries. Patient lives alone.
Initial Impression: Suspected Acute Coronary Syndrome (ACS) / Myocardial Infarction (MI) Justification for F2 Classification: - Severe chest pain with radiation, shortness of breath, diaphoresis, and history of MI are highly suggestive of ACS. - Time-sensitive condition requiring immediate medical intervention to reduce myocardial damage. - Potential for rapid deterioration into cardiac arrest. Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (likely, but requires immediate evaluation) 3. Aortic Dissection (less likely, but must be considered) 4. Pulmonary Embolism (less likely, no risk factors reported) 5. Esophageal Spasm (less likely given the severity and radiation of pain) Required Actions: - Immediate dispatch of ground EMS with ALS capabilities - Early notification of nearest hospital with cardiac catheterization lab - Pre-hospital ECG monitoring and interpretation - Pain management and antiplatelet therapy administration