Hello! Welcome on HCM! Regarding your concern, I would explain that it is important performing a comprehensive differential diagnosis of different causes that may lead to this clinical scenario: - anxiety (considering the stress at work and his age this seems to be the most probable diagnosis) - coronary artery disease - a musculoskeletal issue. The fact that he has pounding headache may be explained by anxiety, but a close monitoring of blood pressure is needed to exclude high blood pressure. Coming to this point, I would recommend consulting with his attending physician and performing some tests: - a resting ECG - a chest X ray study - complete blood count for anemia - thyroid hormone levels for possible dysfunction - PCR and ESR for inflammation - a cardiac stress test would help exclude coronary artery disease. If all the above tests result normal, you should consider anxiety as the main cause of his troubles. In such case, consulting with a specialist of this field would be helpful. Hope to have been helpful! Kind regards, Dr. Iliri