Cardiovascular disease is the most severe cause of death among all non-infectious diseases and accountable for 17.5 million deaths in the world. Heart mortality in patients with DM is frequently associated with prevalence silent ischemia, which is triggered by autonomic neuropathy, thereby decreasing the chest pain felt by them

Inclusion Criteria:

i) Patients diagnosed with STEMI and NSTEMI ii) Both genders iii) above the age of 30 years iv) Patients with acute myocardial infarction with or without chest pain (angina) for 24 hours v) patients who are hemodynamically stable vi) patients without acute decompensated heart failure (ADHF) vii) patients without malignant arrhythmias viii) patients without in Acute Lung Oedem (ALO) condition ix) patients not using ventilator x) patient willing to and become respondents.

Exclusion Criteria:

i) Patients with several complications, thereby making it impossible to interview them ii) patients who have never undergone CABG surgery iii) patients who refuse to be respondents

All cases admitted to ED who meet the eligibility criteria will be recruited in this study after obtaining an informed consent chest pain of DM and non-DM patients with the acute coronary syndrome