Long standing diabetics have what in medical terminology known as neuropathy i.e. the nerve endings are also involved in the diabetic process. So they are insensitive to pain. Generally they do not have angina per se. The cardiac symptoms present as breathlessness and early fatigue. These symptoms in a diabetic patient have to be taken seriously and they should get a thorough cardiac evaluation. Generally heart attacks are preceded by sweating and vomiting and urge of defecation. So they should be given two tablets of chewable aspirin which halts the heart attack. Meanwhile, they should be taken to a nearest hospital with intensive cardiac care facilities. Generally the symptoms of heart attack mimic those of indigestion. When ever such symptoms occur they should not be taken lightly.