Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. A five-story concrete building constructed in 1995. Main entrance has a coded lock; code will be provided to responders. Elevator and central stairwell available. Street parking available. Building has a fire alarm system. Current conditions: 7°C, overcast, light wind. GPS coordinates: 65.6832° N, 18.0914° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing chest pain. Primary symptoms: Substernal chest pain described as pressure, radiating to the left arm and jaw. Secondary symptoms: Nausea, sweating, shortness of breath. Patient is alert and anxious. Skin is pale and clammy. Patient is sitting in a chair in his living room. Medical history: Hypertension, hyperlipidemia, type 2 diabetes. Medications: Metformin 1000mg BID, Atorvastatin 20mg daily, Lisinopril 10mg daily, Aspirin 75mg daily. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient experienced sudden onset of chest pain while watching television. 1405 hours: Pain intensified, radiating to left arm and jaw. Associated with nausea and sweating. 1410 hours: Patient attempted to take a nitroglycerin tablet, but pain did not subside. 1415 hours: Patient called his son for assistance. 1420 hours: Son arrived, called emergency services. 1422 hours: Current time, patient remains in chair, experiencing chest pain. Prior Events: Patient had a similar episode of chest pain approximately 6 months ago, which resolved spontaneously. No prior hospitalizations for cardiac issues. Last medical check-up 2 months ago, routine follow-up.
Initial Impression: Suspected Acute Coronary Syndrome - Non-STEMI Justification for F2 Classification: - Chest pain with radiation, associated symptoms (nausea, sweating, shortness of breath) - Patient has multiple risk factors for cardiac disease (hypertension, hyperlipidemia, diabetes) - Symptoms not fully relieved by nitroglycerin, suggesting ongoing cardiac ischemia - Time-sensitive condition requiring prompt medical evaluation and treatment Differential Diagnoses: 1. Acute Myocardial Infarction (Non-STEMI) (high probability) 2. Angina Pectoris (less likely given severity and duration of symptoms) 3. Aortic Dissection (less likely given lack of tearing pain and neurological deficits) 4. Pericarditis (less likely given lack of pleuritic chest pain) 5. Gastroesophageal Reflux (less likely given associated symptoms) Required Actions: - Dispatch of ground EMS with ALS capabilities - ECG monitoring and interpretation - Oxygen administration and IV access - Pain management protocols initiation - Preparation for transport to nearest hospital with cardiac catheterization lab