We describe a case of a 17-year-old boy presenting to the emergency department following a presyncopal episode with exertion. His medical history is significant for a murmur, which was determined to be benign in nature after a normal echocardiogram at 12 years of age. His workup in the emergency department included an electrocardiogram, which was significant for left ventricular hypertrophy, and a point-of-care ultrasound, which was significant for severe concentric left ventricular hypertrophy with diastolic dysfunction consistent with hypertrophic cardiomyopathy.