Introduction:
Hypertrophic cardiomyopathy (HCM) is a cardiac condition that is defined by hypertrophy of the left ventricle, hypercontractility, decreased compliance, and poor relaxation (1-3). HCM presents as a progressive and chronic condition that may become devastating and life-changing, affecting the quality of life dramatically. Chest pain, palpitations, exertional dyspnea, shortness of breath, ankle swelling, fatigue, dizziness, lightheadedness, and syncope are the most common symptoms identified (2-5). Sudden cardiac death (SCD), Heart failure (HF), atrial fibrillation(AF), and stroke are all related to HCM(6-8). Symptoms might be mistaken with those of other diseases, and an accurate diagnosis may take years. The assumed prevalence is approximately 1:500 adults (9), however only around 100,000 among the estimated 700,000 HCM patients in the United States have been diagnosed (10). Many asymptomatic HCM patients are diagnosed accidentally or through screening (3). Clinical history comprises a complete cardiac history and a 3-generation family history for determining HCM or sudden death relatives (3, 11, 12). Functional and fitness capacity assessment, focusing on training regimen and exertion symptoms—chest pain, palpitations, dyspnea, and syncope (3, 13).
Significant advancement seems to have been achieved in comprehending the disease from both genetic and clinical perspectives (14), although methods of diagnosis have improved (15). Despite genotype positive-phenotype negative people have not being included into HCM prevalence estimations, these individuals are at an elevated risk of acquiring the disease, however, the progression to clinically severe disease remains unpredictable [8,9,10].
By improving timely treatment, proper prognostic classification, and earlier diagnosis can allow for an overall decrease in disease-related mortality/morbidity (16). When it was originally discovered, HCM was considered to be an uncommon disease that largely affected young people and had a poor prognosis due to the potential risk for SCD (17, 18). Currently, it is understood that HCM may impact patients of any age whereas the overall prognosis of a diagnosed HCM patient is usually favorable, with about two-thirds enjoying an ordinary lifespan with almost no morbidity and an average HCM-related mortality that is approximately 0.7%/year  (19-21). Some patients, however, are at an elevated risk of SCD or developing atrial fibrillation (AF)/heart failure (HF). As a result, identifying these individuals is a critical priority (2, 22).
Echocardiography is the gold standard for HCM screening, diagnosis, follow-up, and prognostic classification (2, 22, 23). Recent SCD risk calculators authorized by the AHA and the ESC (2, 22), include echocardiographic measures. Advanced echocardiographic techniques (two-dimensional speckle tracking, tissue Doppler) are able to distinguish HCM from different causes of hypertrophy and recognize people who are susceptible to developing HF or SCD. 3D echocardiography provides greater information about hypertrophic distribution, the mechanism of dynamic LV obstruction, and LV mass (23).
Our study aims to explore the connection, between reported symptoms and suspected HCM (Hypertrophic Cardiomyopathy) during echocardiographic screening. While echocardiography is a tool we believe it could be more useful if we can determine whether specific symptoms are linked to a higher likelihood of detecting HCM. By understanding the relationship between symptoms and suspected HCM we can improve risk assessment.  Our main objective is to contribute to the growing body of knowledge about HCM, which will lead to more effective practices and earlier detection of this life-threatening condition.