Some are classic angina. Some are acute MIs. Some get toned as chest pain, and it ends up being the kidneys. But each one, while the same, is also different.
Last shift I had two actual STEMIs, one getting a nitro drip (which I love... even if it is math), though neither met criteria to do a Code STEMI activation.
And the shift before that, I actually had an NSTEMI, which I got to see progress from just 2 leads, through nearly all of them. The patient SHOULD have been flown from the scene, but dispatch didn't dispatch the helicopter, even though it met auto-launch criteria. We got to the ED, the doc (my medical director) looked at my progressing 12-leads (was happy that I did right-sided 12s as well), called in to the cath lab, and off the patient went.