Have you seen an HCM specialist ? or spoken with the HCMA ? That is where I would start.
The septal defect may be part of your symptom. There is a hole in the septal wall that separates the right and left side. Under pressure oxygenated blood from the left side (blood rec'd from the lungs) abnormally flows into right side (blood that goes to the lungs to be oxygenated). The consequence is a deficit of blood pumped into circulation with each heartbeat. That can be corrected with minimum intervention if and when it becomes more serious.
Mitral valve regurgitation (moderate) further reduces the amount of oxygenated blood pumped into circulation by the back flow blood from the left ventricle to the left atrium. There can be valve repair with minimal intervention if required. Moderate regurg is a condition that whould be addressed and corrected especially at the age of (44), uncorrected can cause left ventricle dysfunction leading to an enlarged LV and poor contractility.
There is some pulmonary hypertension, but the right ventricle functions properly.
That is a breakdown of the medical problem. Treatment would be to reduce the heart's workload by controling blood pressure, etc.
You may want to contact an interventional cardiologist for an assessment.