Hypertrophic cardiomyopathy (HCM) can occur at any age along the lifespan, from the very young to the elderly. Its clinical manifestations and associated symptoms are diverse, ranging from asymptomatic left ventricular hypertrophy to exercise intolerance, heart failure, and death or transplant. Arrhythmias in HCM often focus on ventricular tachycardia, a potentially lethal consequence. However, among adults with HCM, atrial fibrillation is the most common rhythm disturbance, which can lead to consequences like stroke. Two recent articles highlight that pediatric HCM has a distinct spectrum from adult onset HCM.1,2 Patients with pediatric HCM who are symptomatic represent a high-risk group that may warrant more aggressive management.