hypertrophic cm in 3 year old

  Hello, Thank you for answering previous posts for myself.  I have a question about my son who is 3 who has apparently inherited hcm from me.  At age 2 he had an ekg which showed left ventricular hypertrophy.  An echo at that time revealed a normal heart, with a lv measruement in the high normal range.  16 months later, at age 3 he had a repeat ekg, which still showed lvh.  The echo, however, showed IHSS with the septal measurement at the thickest point being 18 millimeters.   A holter monitor (boy that was a fun experience!) revealed no arrythmia.  He will have repeat echo's every 6 months.   Is this extremely serious?  Everything I have read states that hcm usually doesn't present until puberty.   Also, with this septal measurment, does my son need to be seen by someone who specializes in pediatric hypertrophic cardiomyopathy, or is he ok being followed by a regular pediatric cardiologist?  As far as I know, he has no symptoms - he runs around and plays like any normal 3 year old.
  Thank you so much for answering my posts.
  Barbara

[CCF Cardio MD - MTR]

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Dear Barbara, thank you for your question.  It's hard for me to give you accurate information regarding your son since I haven't evaluated him.  But, the septal measurement is increased which probably indictaes HOCM is present.  Your son should be followed by a good pediatric cardiologist because there are few pediatric cardiologists who specialize in HOCM (which is a rare disease in children).   Your son's cardiologist is best equipped to answer questions about prognosis.  
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