Brief Answer: needs further evaluation. Detailed Answer: Hi, Thanks for using XXXXXXX I went through the query and understood your concern. Cough on deep inspiration and expiration may be due to any irritation in the pleura or any lung problem like mild mid airway restrictive disease or reflux disease. The pain in upperback with cough may be due to musculoskeletal pain or reflux disease. But the cough on deep inspiration with the fluttering heart, upper back pain and left side headache with the history of diabetes and hypertension needs cardiac evaluation first and then respiratory system, as even with pericarditis otr in angina these problem may occur. But this will also presents with other features like chest pain, variation in BP etc. I hope the fluttering heart you mentioned referred to palpitation or arrhythmia. Since you are diabetic the pain may be very minimal or no pain at all. so I advice you yo consult your doctor once to ruleout any problem in heart and lungs. Your doctor may advice ECG, cardiac enzymes, chest x ray, or spirometry based on the examination. So before diagnosing your problem a detailed cardiovascular and respiratory system examination is required. The management depends on the findings. So I advice you to get detailed examination once. Hope this information helps you. Feel free to ask if any related query and I will be glad to answer them. wish you faster recovery and good health. Regards

---