@mpjg Thank you for words, they are encouraging, I am sure my card team here in Louisville do not have experience with this, so I am scheduled in Cleveland in March, even if I feel better by then on Camzyos I am going for the whole workup there. I just found out I also have "severe left atrial dilation". One cardiologist didn't say a word about it, no one mentioned it until I brought it up to the NP at the Heart Failure Clinic, and she said, oh yeah, that's a completely different condition and it's very serious, and your cardiologist should have taken care of that, another one told me, yeah that's cause by the HOCM with SAM and it should have been addressed as well..... ugh, I feel like I am having to do everything myself for them. They don't have the experience here. I just want to start feeling better and stop being told I am at high risk for sudden cardiac death due to the gradient of 214... Im sure time will make things better but today I feel defeated.