Hello! Thank you for asknig on HCM! Your complains raises strong suspicions of probable ischemic cardiac pain. Recurrent episodes of chest pain for minutes, especially when being on physical axtivity, need a comprehensive differential diagnosis to rule out cardiac ischemia. At this point, I would advice you to perform a medical check up, a physical examination to identify your heart failure status, coupled with a resting ECG and some blood tests (including cardiac enzymes like CK-MB, Troponin). If any suspicions is confirmed, then a cardiac ultrasound and an exercise stress testing would be helpful. Obviously a modulation of heart failure therapy, as well as additional anti-ischemic medications may be needed. If all the above diagnostic work up confirm ongoing cardiac ischemia, then a coronary angiography is necessary to conclude about the concrete coronary lesions and possible revascularisation options. Hope to have been helpful. Greetings! Dr. Iliri