As an agency nurse that fluctuates units I tend to get TONS (up to 10) reported Chest pain cases during the first day of my rotation. The inmates know what s/s to say they are experiencing. I tend to go cellside and do an observation/assessment and go from there. Many of them want a conversation by a new face. Of course I work in a facility right now that is a 24 hour lockdown, one nurse, no provider, and up until now the nurse has been male or elderly.
A person experiencing a true MI or cardiac emergency are fairly easy to spot. Diaphoretic, vitals abnormal, demeanor off, EKG abnormality, guarding, etc. Usually I have a baseline EKG for comparison so that helps too. If you are familiar with your patient it helps as you can tell if they are in distress and not their "normal" selves.