Hello! Thank you for asking on HCM! I understand your concern, and would like to explain that, facing her doctor has ruled out cardiac issues, further investigations should be performed on alternative directions. First to rule out any Rheumatoid arthritis exacerbations. A physical exam with some additional lab tests, like complete blood count, PCR, ESR, RF, X ray films study, etc are necessary for the differential diagnosis. Meanwhile, check her blood pressure and try any anti-inflammatory medications. If the complains persist, you should visit an ER doctor without delay for some preliminary tests. If after all diagnostic work up, nothing new results, then an optimisation of fibromyalgia management should be implemented. Drugs like duloxetine, etc, could be helpful. You need to discuss with a specialist on the field (neurologist) on that issue. Hope to have been helpful to you. Greetings! Dr. Iliri