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Sudden death / unusual collapse in young person - ? HOCM

autosomal dominant disorder of muscle tissue caused by defects in the genes encoding contractile proteins. 
most common defects involve a mutation in the gene encoding β-myosin heavy chain protein or myosin binding protein C. 
estimated prevalence is 1 in 500.

''Features''
    often asymptomatic
    dyspnoea, angina, syncope
    sudden death (most commonly due to ventricular arrhythmias), arrhythmias, heart failure
    jerky pulse, large 'a' waves, double apex beat
    ejection systolic murmur: increases with Valsalva manoeuvre and decreases on squatting

''Associations''
    Friedreich's ataxia
    Wolff-Parkinson White

''Echo - mnemonic - MR SAM ASH''
    mitral regurgitation (MR)
    systolic anterior motion (SAM) of the anterior mitral valve leaflet
    asymmetric hypertrophy (ASH) 

''ECG''
    left ventricular hypertrophy
    progressive T wave inversion
    deep Q waves
    atrial fibrillation may occasionally be seen