“If you pass, it doesn’t hurt, if you don’t pass, it hurts.” It seems to make sense, but there are times when it doesn’t work. Today, we’re going to talk about painless heart attacks, a complication of diabetes that “doesn’t pass” but “doesn’t hurt”. Is diabetes prone to heart disease? In the May 2016 issue of Circulation, the ARIC study published data on asymptomatic myocardial ischemia (SMI) and found that SMI accounted for 45% of all heart attacks. It has been shown that diabetic patients have a 2-4 times increased risk of coronary artery disease and often have multibranch lesions, poor prognosis for interventional therapy, and a high prevalence of atypical angina, painless myocardial infarction (infarction), and non-Q-wave infarction. Diabetic patients have a 57% increased mortality rate from unstable angina and non-Q-wave infarction. How does it happen? Why is it painless? Can it be detected early? Peer into the details to find the truth. Painless infarction, is painless, but also sometimes it is also will leave some clues, if suddenly appear unexplained panic, fatigue, shortness of breath, can’t lie down, coughing, sweating, lower blood pressure, pale, nausea and vomiting, abdominal distension and diarrhea, cardiac arrhythmia, pulse is weak and irregular, confusion and other signs and symptoms, should be thought of acute myocardial infarction, should be dealt with in a timely manner and rushed to hospital for medical treatment, do We should promptly handle the case and send the patient to the hospital for an electrocardiogram, myocardial damage marker measurement, and coronary angiography, etc., so that early diagnosis and treatment can be made to prevent the occurrence of adverse consequences.