I am female, 71 yo, have myasthenia gravis, HTN, pre-diabetes, overweight, high stress situation, low energy/low activity. I take meds for myasthenia, HTN, and stress, and have changed my diet to eliminate (almost) sugar. I stopped taking estrogen 18 months ago, after almost 30 years of taking it. I have had severe hot flashes frequently, day and night since stopping the estrogen. I also notice irregular heartbeat and pain in my right arm/shoulder occasionally. Should I ask my internist for a referral to a cardiologist? Thank you! Oh, I also have Arnold Chiari malformation, type I. (surgically treated in 1988).