Hi @joycehocm . I can't speak to why a cardiologist would recommend either medication or surgery - that's way beyond my expertise but your cardiologist and COE specialist can answer that. My own personal view on it is that in one case I take a medication (an expensive one, for the rest of my life, admittedly). In the other case, someone either chemically burns away part of my heart muscle, or they break open my chest and slice out pieces of the heart. (I'm being over dramatic, I admit.) I had abdominal surgery (not heart surgery) and it was into a the second year after that I finally quit experiencing physical pain and emotional distress. I have no desire to repeat that, and the whole idea of someone slicing away pieces of my heart gives me the screaming heebie-jeebies. Yes, I'd do it if there were no other option, but I'd want to try other options first. You might rightly ask why I would chose to toss chemicals into my body that interfere with the way my heart is working. I guess one option just scares me more than the other. As for the expense, I'm in Canada where things maybe work a little differently from the US, and I have an amazing health care plan that covers most of the expense. For all the slagging that goes on about "Big-Pharma", I have to say that Bristol Myers has been very generous about covering what my health care plan doesn't, and I'm grateful. For what it's worth, my experience on Camzyos has been literally life changing and I'm so happy to have had that option. But my advice is worth what you paid for it. Listen instead to to your specialists. Get second opinions if you think you should. Wherever you end up - good luck!