Thank you for your response. I think I am drinking enough water, but maybe not. I fill up my 32 oz water bottle at least 4 times a day (with ice). I had labs done recently and my electrolytes are normal. Good advice about looking for a new cardiologist. I'm fairly new here and don't really know the reputations of the heart doctors. I have an ICD and there is one electrophysiologist. I don't think my cardiologist knows much about HCM. I get the feeling that he is learning as he goes. Not too comforting to me at this point. I have ApicalHCM and my Dr. said that the stress echo did not show any blockage so my chest pains must be coming from something else besides my heart. Is this right?