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A 69 year old woman was referred for cardiac assessment with dyspnoea (New York Heart Association functional class III). Her ECG showed sinus rhythm with right bundle branch block and T wave inversion in inferior leads II, III, and AVF (upper panels, A) An echocardiogram revealed presence of hypertrophic cardiomyopathy (HCM). Interventricular septum was severely thickened at 2.9 cm (lower panel, A). There was …