“…[15] Many pediatric HCM patients are asymptomatic, and consultations are mostly for evaluation of cardiac murmur, abnormal ECG and chest x-ray. Another reason is an investigation of cardiac involvement in conditions such as malformation syndrome, an inborn error of metabolism (IEM), or neuromuscular disorders [11,18,19] . In symptomatic patients, fatigue, syncope, palpitations, chest pain, at rest or exertion, and symptoms of heart failure account for most cases [2,20] .…”