Pain in the chest that spreads to the left shoulder and arm, as a primary symptom of heart attack may be present for up to twelve hours.
Another condition that can give similar symptoms like heart attack that last longer is aortic rupture.
Also, the arteries wall rupture can happen at the coronary arteries (the one that supply the heart muscle), that are branches of aorta (the main blood vessels that leaves the heart), resulting in heart attack.
In other words, the aortic rupture can cause heart attacks as a complication.
A simple chest x-ray may help in detecting aorta rupture.
Another possible scenario is a blood clot in the arm artery that stops the blood flow to the arm, resulting in very severe pain, changing skin color of the arm and changed sensations.
This blood clot can be detected by using an ultrasound (doppler ultrasound) for arm arteries.
Best wishes!
Marija