Hafnarstræti 23, 600 Akureyri. Ground floor of a two-story wooden building built in 1955. Main entrance on street level, no stairs. Back entrance locked. No elevator. Street parking available. Building has basic fire alarm. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6821° N, 18.0912° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm and jaw, shortness of breath, diaphoresis. Patient reports sudden onset of symptoms. Secondary symptoms: Nausea, dizziness. Patient is pale and anxious. Patient sitting on a chair in his office. Medical history: Hypertension, hyperlipidemia, type 2 diabetes. Medications: Metformin 1000mg twice daily, Atorvastatin 20mg daily, Lisinopril 10mg daily, Aspirin 75mg daily. No known allergies. Last meal was a light lunch at 12:00.
Timeline: 1315 hours: Patient experienced sudden onset of severe chest pain while working at his desk 1316 hours: Patient reports pain radiating to left arm and jaw, difficulty breathing 1317 hours: Patient became diaphoretic and nauseous 1318 hours: Patient called his son, who works in the same building, for help 1320 hours: Son arrived, called emergency services 1322 hours: Current time, patient still experiencing chest pain, sitting in chair Prior Events: Patient reports occasional mild chest discomfort in the past, never this severe. Last medical check-up 6 months ago, routine follow-up. No recent illnesses or injuries. Patient is a smoker (20 pack-years).
Initial Impression: Suspected Acute Coronary Syndrome (ACS), likely Myocardial Infarction Justification for F2 Classification: - High probability of cardiac event based on classic symptoms (chest pain, radiation, diaphoresis, dyspnea) - Time-sensitive condition requiring immediate medical intervention to limit myocardial damage - Potential for rapid deterioration to life-threatening arrhythmia or cardiac arrest Differential Diagnoses: 1. Acute Myocardial Infarction (high probability) 2. Unstable Angina (likely) 3. Aortic Dissection (less likely, no ripping pain) 4. Pulmonary Embolism (less likely, no pleuritic pain) 5. Esophageal Spasm (less likely given severity and radiation) Required Actions: - Dispatch of ground EMS with ALS capabilities - Initiate cardiac monitoring and ECG - Oxygen therapy and pain management protocols - Preparation for rapid transport to nearest hospital with cardiac catheterization lab