This is a rare case of HCM with obstruction, but not due to SAM of AML but due to SAM of chordae. The chordae here are very slacking so that they are in direct relation with the flow towards the LVOT. This is another evidence for us that the guiding forces of SAM in classical HOCM are not due to Venturi effect but due to flow drag forces.
This patient presented with atypical chest pain.
In this video there is an asymmetric septal hypertrophy, and there is a diastolic anterior motion
There is a moderate MR( not shown).
This combination of systolic anterior motion of chordae and diastolic anterior motion of AML is very rare.
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