We report the case of a symptomatic 18-year-old patient, gene-positive for hypertrophic cardiomyopathy (HCM), who presented with symptomatic dynamic left ventricular outflow tract (LVOT) obstruction caused by an abnormally thickened papillary muscle in the absence of septal hypertrophy. This was confirmed using multimodality imaging, including echocardiography and magnetic resonance imaging. He successfully underwent surgery for papillary muscle realignment without septal myectomy.
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