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Q2 A 38-year-old man symptomatic with exertional dyspnoea (NYHA III) and angina (CCS II) was diagnosed with hypertrophic obstructive cardiomyopathy. Transthoracic echocardiography (Panel A.1. parasternal longaxis view, A.2. short-axis view) demonstrated pronounced asymmetric septal hypertrophy (septal wall thickness 31mm) with supranormal left ventricle systolic function (ejection fraction 80%), resting systolic anterior motion of mitral valve, left ventricle outflow tract (LVOT) obstruction with a peak rest gradient 19mmHg and 76mmHg after provoking test and an unusual

"A trefoil sign" in patient with myectomy for hypertrophic obstructive cardiomyopathy