Hello! Welcome and thank you for asking on HCM! I passed carefully through your question and would explain that it is important performing a comprehensive differential diagnosis between different possible causes that may lead to this clinical scenario: inflammation or a musculo-skeletal pain, a lung disorder, a cardiac issue, etc.. Coming to this point, I would recommend performing further tests to investigate for the possible underlying causes: - a chest X ray study and pulmonary function tests - complete blood count, PCR, ESR for inflammation - an exercise cardiac stress test to exclude myocardial ischemia - thyroid hormone levels to exclude a thyroid gland dysfunction. You should discuss with your doctor on the above tests. Hope you will find this answer helpful! Kind regards, Dr. Iliri