This child has symptomatic hypertrophic obstructive cardiomyopathy and also Wolff-Parkinson-White syndrome. On beta-blocker medication since the age of 6 months. Thick (12 mm) ventricular septum. Left ventricle outflow tract is clearly obstructed; however, there is a laminar flow in the ascending aorta with a velocity of 1.2 m/s. On auscultation an almost third-degree murmur is heard that is somewhat coarser and longer lasting than the physiological sound. Phono- and spectrograms both match mild stenosis, but also strong physiological vibration sound. Age 3.8 years. Area of auscultation: left fourth ic (LIC4).