“If I have seen further it is by standing on the shoulders of giants.”

Isaac Newton 1676

In 1958, Donald Teare, a forensic pathologist in London, reported eight cases of sudden death caused by “asymmetrical hypertrophy or benign tumour” of the heart in the British Heart Journal.1 All were adolescents or young adults who, before death, had presented with arrhythmia, recurrent blackouts or severe right heart failure. At post mortem, they each had localised hypertrophy of the interventricular septum, a coarse myocardial texture and a bizarre arrangement of muscle fibres, separated by connective tissue and clefts. While Teare could not know the cause of these abnormalities, with some prescience he concluded that the differential diagnosis lay “between a congenital and a developmental origin”. One wonders what he would have made of the discoveries that were to follow.

In this special issue of Heart, we celebrate the 50th anniversary of Teare’s paper, widely regarded as a classic citation. In a series of specially commissioned papers, clinicians, whose careers span the half a century since Teare’s publication, review the pathogenesis, diagnosis and treatment of hypertrophic cardiomyopathy. These themes are explored in greater detail in a series of original papers written by present-day investigators.

In the first review (see page 1258), Caroline Coats, a research fellow new to the field of hypertrophic cardiomyopathy (but whose curiosity and enthusiasm …