Hypertrophic cardiomyopathy (HCM) is a genetic cardiomyopathy. The prevalence of 
phenotypic expression, in the absence of another systemic or cardiac disease 
causing increased left ventricular (LV) wall thickness, is estimated to be 
1:500. The frequency of clinical presentation is far less, highlighting the need 
for a non-invasive diagnostic imaging tool. Echocardiography is readily 
available and allows for structural characterization and hemodynamic assessment 
of the hypertrophic heart and to screen patients at-risk for HCM, such as first 
degree relatives of affected individuals, and differentiate HCM from the 
athletic heart. Echocardiography can also be used to assess for anatomic 
abnormalities of the mitral valve apparatus that may exacerbate LV outflow track 
obstruction and to further risk stratify patients during exercise. Finally, 
echocardiography plays an integral role in guiding alcohol septal ablation 
procedures.