Hello! Thank you for asking on HCM! Regarding your complain I would recommend you to first identify if any arrhythmia is present. For this purpose, I recommend an ambulatory ECG and BP monitoring to identify abnormal heart rhythm and BP. A cardiac ultrasound and some blood tests (including cardiac enzymes), if not performed, are necessary to rule out any serious cardiac implications. A digestive tract follow up is necessary to rule out any responsible disorders, like hiatal hernia, GE reflux, or gastritis, etc). After initial work up, and excluding presence of arrhythmia, and other organic causes, anxiety investigation should be ruled out. Hope to have been helpful. Greetings! Dr. iliri