A44year old female awakened with shortness of breath complaining of indigestion, epigastric pressure. antacids didn't . you should suspect?

I would suspect Heart Attack, but hiatal hernia- a condition in which the upper part of your stomach bulges through an opening in your diaphragm.

Explanation:

The symptoms sound like those of heartburn, but seeing that antacids didn't have any effect. Antacids neutralize (reduce) excess stomach acid to relieve heartburn, sour stomach, acid indigestion, and stomach upset. They can also be used to relieve the pain of stomach and duodenal ulcers.

https://my.clevelandclinic.org/health/treatments/9624-heartburn-treatment

Shortness of breath, epigastric pressure are one of the four silent signs of a heart attack. You usually have to look past chest pain, to give a resolute diagnosis. They often suffer from subtle symptoms such as:

Pain in the arms, neck or jaw

   Sweating or “cold sweat”

   Unusual fatigue

   Feelings of fullness, indigestion or choking (also symptoms of heartburn)

   Nausea or vomiting

   Lightheadedness, dizziness, extreme weakness or anxiety

Symptoms of a hiatal hernia

It’s rare for even fixed hiatal hernias to cause symptoms. If you do experience any symptoms, they’re usually caused by stomach acid, bile, or air entering your esophagus. Common symptoms include:

   shortness of breath

   heartburn that gets worse when you lean over or lie down

   chest pain or epigastric pain

   trouble swallowing

   belching

I know this is long, but i hope it helps lol . ^-^