Hello I Had A 55 Year Old Male With No

hello I had a 55 year old male with no pertinent health history no medications no allergies who had 6 on 10 sharp back pain that started 2 am that woke him up out of sleep. ignored the symptoms till noon diaphoretic 6 on 10 chest pain along with the back pain. Nausea dizziness. 4mm stEMI v1 v2 v3 v4 with recipical changes. Patients catholic was normal. What else could cause those changes.