Another possibility is an esophageal spasm.
A little bit of acid reflux and the esophagus slams shut and cramps. The symptoms can PERFECTLY mimic all five of those of a heart attack.
Ironically, nitroglycerine relaxes the muscles and relieves the pain.
Obese middle-aged man shows up in the ER with all the symptoms of a heart attack, treatment with nitro relieves the symptoms, the doctors were convinced I had a bad ticker!
I spent 4 days in a hospital, EKG, stress test, non-stress test, thallium scan, and finally an angiogram, which showed definitively that my arteries were as clear as those of a 20 year old.
Reluctantly, they let me go...
I am sure I had one of those once. Since I’d studied the signs of a heart attack I knew I didn’t have some key ones and just suffered through some INTENSE pain until the next morning when I could get some antacid.