Hi @lucy4 , another fellow Canadian here. 61 year old male. What a frustrating journey you are on. To (kind of) answer your question of "how long/how hard" ... I had been fighting with progressively worsening symptoms for something along the lines of 15 years. All of the above - shortness of breath, fatigue, chest pain, fog, the works. It was all a mystery for years until one doctor sent me for (another) echo, who sent me to a specialty centre where they did (yet another) echo. At that point I had three doctors saying HCM and I got referred to an HCM clinic where they did (ready?) ANOTHER echo. The techs aren't allowed to tell you anything of course but they quietly muttered to me that the results were crystal clear and there was a clear and unambiguous answer on the way, and I got scheduled for a cardiac MRI, which of course took months. MRI done and the HCM specialist said "nope, not HCM," and when I asked ok, what is it, what should I do next, his response was (and I quote verbatim): "I dunno man." Fast forward approximately another 3 years (I've lost track of the exact timeline now), my family doctor sent me for an echo after hearing "something different from last time" during my annual physical. Cardiologist called me in after reading the echo and basically said "classic, textbook Obstructive HCM." He recommended Camzyos which took just a few weeks to get all worked out, and BAM! - the world changed. After 12 days on Camzyos I had zero symptoms and have had no negative side effects except a tiny increase in blood pressure, now firmly under control.

All that to say... Yeah, it can be a LONG, frustrating road of conflicting answers, and no-answers, even from those who you expect to know. After getting my hopes up again and having them dashed by "I dunno man", I sat on a bench outside the hospital and cried. Big, ugly snot-sobs. And not for the first time. I can't count the number of times over those earlier years that I said to my wife that I didn't want to chase an answer anymore - it was just easier to accept that I would continue to slowly lose all physical ability to even tie my shoes unassisted. Riding that roller coaster of hope and despair was so disheartening.

Do you have HCM? I don't know. Do you need Camzyos? I don't know. Do you need surgery? I don't know. I'm just an engineer and all that stuff - including all of the echo numbers you reported - it's WAY beyond me. But try not to lose hope. If you feel like you are getting conflicting echo results, maybe see if your family doctor will refer you to a different clinic for an echo. Don't be afraid to travel to another centre a few hours away for that if necessary - sure it's inconvenient, but in the end it might be worth it. Like @karukgirl said, be persistent. If you haven't already done so, create and maintain a diary of EVERYTHING that triggers your symptoms. I was up to about 30 pages at one point. Somewhere in all that might lie the nugget that makes a light come on for one of the doctors.

Finally, while you are recovering from bouts of chest pain or dizziness or sortness of breath, spend a bunch of time perusing the HCM forums here. It's a gold mine, and I can almost guarantee you will see your own reflection looking back at you in some of the stories you see here. Don't lose hope. Keep trying. Have a good cry now and then. Then pick yourself up and start kicking and raging at it all over again. "Do not go gentle into that good night" (Dylan Thomas).