Hafnarstræti 18, 600 Akureyri. Ground floor of a two-story commercial building, built in 1965. Main entrance is at street level, no stairs. One rear exit to parking lot. No security features. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6832° N, 18.0895° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm, shortness of breath, diaphoresis. Secondary symptoms: Nausea, lightheadedness. Patient is conscious and anxious. 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 10mg daily. No known allergies. Last meal was a light lunch at 12:30.
Timeline: 1345 hours: Patient reports sudden onset of severe chest pain while working at his desk. 1347 hours: Patient experiences radiating pain to left arm, shortness of breath, and diaphoresis. 1349 hours: Patient calls his son for assistance. 1351 hours: Son arrives, calls emergency services 1353 hours: Current time, patient still experiencing severe chest pain. Prior Events: Patient has a history of hypertension, hyperlipidemia, and type 2 diabetes, managed with medications. He has experienced occasional mild chest discomfort in the past, but never this severe. Last medical check-up was 6 months ago, routine follow-up. Patient is a non-smoker, but has a history of smoking until 10 years ago.
Initial Impression: Suspected Acute Coronary Syndrome (ACS), likely Myocardial Infarction Justification for F2 Classification: - High probability of cardiac event based on symptom presentation and risk factors - Patient experiencing severe chest pain, radiating to left arm, shortness of breath, and diaphoresis - Time-sensitive condition requiring prompt medical evaluation and treatment Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (likely, but less severe than MI) 3. Aortic Dissection (less likely given lack of tearing pain) 4. Pulmonary Embolism (less likely given lack of pleuritic pain) 5. Musculoskeletal Chest Pain (less likely given severity and radiation of pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - Initiate cardiac monitoring and oxygen administration - Obtain 12-lead ECG - Preparation for transport to nearest hospital with cardiac catheterization lab