Good evening Doctor, I noticed for a while now (two months more or less, I don t really remember) that sometimes (mainly during physical effort), when I cough, I feel a sharp pain in my shoulders and down to my arms... What can it be? I m 25, male, smoker, I drink rarely, very low sexual activity, suffering from high stress, desk job (not enough exercise), no family history for diabetes or obesity, heart disease present in males from my mother s side... I hope these details can help. Thank you for answering in advance.