Hello! Welcome and thank you for asking on HCM! Your symptoms don t seem to be cardiac related. A musculo skeletal pain and pain related to pleuritis could be modulated by the respiratory movements, but would not be related to the tobacco chewing. Another disorder would be esophageal spasms or gastritis, which would be exacerbated by the tobacco chewing. Have you tried to take any painkillers (acetaminophen, ibuprofen)or PPIs (lansoprazole, omeprazole)? The pain relief from painkillers would indicate a musculoskeletal pain. The pain relief from PPIs would indicate a gastro esophageal disorder. I recommend consulting with your GP for a careful physical examination, a resting ECG, a chest x ray and some blood lab tests (complete blood count, PCR, sedimentation rate, kidney and liver function tests, etc). A fibrogastroscopy would be necessary to exclude a possible gastro esophageal disorder. Hope to have been helpful! Best wishes, Dr. Iliri