HCM: A disease of energy deficiency

HCM: A disease of energy deficiency. ADP = adenosine diphosphate; AMP = adenosine monophosphate; ATP = adenosine triphospate; Cr = creatine; FAM = fatty acid metabolism. [Source]

As indicated in red, the phenotype of hypertrophic cardiomyopathy (HCM) can arise from:

Sarcomere disruption in hypertrophic cardiomyopathy (HCM)

Sarcomere disruption in hypertrophic cardiomyopathy (HCM).
ACE = angiotensin-converting enzyme.
[Source]

Hypertrophic cardiomyopathy (HCM) is thought to occur primarily through sarcomere disruption in the face of intact cytoskeleton/sarcolemma.

Hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy is the single, most common cause of sudden death in young athletes. The majority of patients are asymptomatic or only mildly symptomatic. Syncope and sudden death are associated with severe exertion and competitive sports, which should be avoided in patients with hypertrophic cardiomyopathy. The most common symptom is dyspnoea.