The parasternal long axis view is a good view to assess for left ventricular hypertrophy as well as mitral valve abnormalities in patients with HCM. The presence of systolic anterior motion of the mitral valve is assessed by 2D imaging and by using M-mode echocardiography and is characterised by mid-systolic notching of the aortic valve and contact of the anterior mitral valve leaflet/chordae with the ventricular septum.   Systolic anterior motion of the mitral valve nearly always results in failure of normal leaflet coaptation causing mitral regurgitation, which is typically mid-to-late systolic. In obstructive HCM, the interventricular septum is much wider, with a smaller LV cavity, and greater incidence of mitral insufficiency, generally directed towards the posterior wall of the left atrium.