Anomalous papillary muscle insertion in hypertrophic cardiomyopathy.

Half of the patients with hypertrophic cardiomyopathy (HCM) have left ventricular outflow (LVOT) obstruction as a result of systolic anterior motion of the mitral valve. A 51-year-old man with HCM presented with exertional dyspnoea and syncope refractory to medical therapy found to have an LVOT gradient of 27 mmHg at …