Hi, thanks for posting your concern in the HCM. Perimenopausal women may have several symptoms including increased irritability, hot flush, back ache, night sweats, pain during intercourse, breast discomfort, anxiety etc. However, in case of chest discomfort with discomfort in both hands, with fluctuating BP level, you should have an ECG (A TMT may also be required) to rule out ischaemic heart disease. If you feel a radiating pain or discomfort or tingling and numbness of the upper extremity with or without upper back or neck pain, a cervical spine xray may be needed. You should also stay on a salt restricted diet to prevent development of hypertension. My recommendation is to consult your local physician for further evaluation. If no abnormality is found clinically and the tests results come out with normal reports, consider it being caused due anxiety disorder related to menopause. Have relaxation sessions daily. Please consult your gynaecologist also for consideration regarding Hormone Replacement Therapy. Regards. Dr. Kaushik