Hello irfan. Thanks for posting at HCM. Your ECG says inferior wall ischemic changes which means that the lower part of the heart is struggling with its blood supply. It is possible that you have sustained a heart attack already. Since your sugars are low I suppose you are on medications for diabetes. Diabetics do not have symptoms of chest pain during a heart attack. You should definitely get checked up at the earliest. You have to see a cardiologist (heart specialist). You have to get a 2D echo done which will confirm the ECF findings if you really had a heart attack. If 2 d echo shows inferior wall changes then next step is an angiography which is an invasive procedure done through a small prick on your hand or leg. It will show whether your heart arteries have blockages and their severity. You may be advised angioplasty or bypass surgery or medical management on basis of angiography findings. This is important and you should get evaluated at the earliest. Please revert back with 2 d echo findings and also if you have any queries. Don t take this lightly. Your fasting sugars are also low so you also have to monitor your sugars closely Wishing you good health. and skip respective dose if sugars are lower than 100. Also you have to see your diabetologist for medication optimization. Regards