Hypertrophic cardiomyopathy is the term for a heterogeneous group of disorders for which various mutations of genes involving proteins of the cardiac sarcomere lead to hypertrophy of various segments of the left ventricle. The hypertrophy can involve the left and/or right ventricle, be symmetric or asymmetric, involving the septum, free wall, mid-ventricle, or apex. The phenomenon of solitary papillary muscle hypertrophy is rare with only 2 references in the literature. Furthermore, giant negative T and U waves are 2 common electrocardiographic phenomena in hypertrophic cardiomyopathy and have been attributed to hypertrophy of the posterior papillary muscle. Solitary hypertrophy of the anterior papillary muscle might be a new echo-electrocardiographic syndrome.