Echocardiographic changes typical of hypertrophic cardiomyopathy are most often seen in patients with obstructive cardiomyopathy. The echocardiographic manifestations of hypertrophic cardiomyopathy include the following: first, significant hypertrophy of the septum, greater than or equal to 1.5 cm, with a ratio of septal thickness to upper left ventricular free wall thickness greater than 1.3-1.5. second, anterior mitral valve leaflet shifts anteriorly in systole, close to the septum. Third, the left ventricular outflow tract is narrowed. Fourth, the aortic valve is partially closed in mid-systole.