Questions: What is the difference between hypertrophic cardiomyopathy vs simple physiological left ventricle hypertrophy? History: The ECG for my father (52, M) showed an abnormal r wave progression (early transition) and the printed ECG had the words "probable left ventricular hypertrophy" on it. My father isn't hypertensive, doesn't smoke or drink nor does he have weight issues. He exercises but not as excessively as a professional athlete (walks at a slow-medium pace for 1.5-2 hours every day). His resting heart rate is usually between 65-70. No exercise intolerance. The only symptom he has is a pain in his right shoulder that worsens when pressed (seems tender, no lymph node involvement). Given all of this, what is the difference between hypertrophic cardiomyopathy and plain LVH. As I understand, the former is a genetic condition but if someone presents with LVH, when does he/she have LVH and when does he have HCM because even HCM needs LVH (greater than 15 cm)? We've had no sudden cardiac deaths in our family that we remember (just strokes and one cardiac death as a complication of diabetes). In the same vein, how do we take this further? Do we need to schedule a 2D echo or something else (genetic tests?). Thanks!