Hello! Thank you for asking on HCM! I understand your concern, and would like to explain that most of your complains may be related to menopause. What is recommended to you is an optimal blood pressure management through appropriate medicine prescription (there are several alternative classes and drugs to ACEIs that produce coughing, so don t worry). As you are under thyroid hormone replacement therapy, a beta-blocker would be preferred to be part of BP maintenance therapy. You should talk with your doctor about these issues. Your menopause storm will pass away soon, so don t worry. Just discuss with your gynecologist for some symptomatic relieving drugs. Judging on pounding heart, it is necessary to have a thorough view on that mitral valve issue. An actual cardiac ultrasound would help to determine any severe valve involvement, with an important contribution to tachycardia. Just talk to your cardiologist about this issue. If you keep going on a healthy life style, fight your potential coronary risk factors (high BP, dylipidemia, etc), and follow a a properly tailored medical management of your health problems, you are going to live a long, and uncomplicated life. Hope to have been helpful to you. Greetings! Dr. Iliri