High-risk individuals are defined as those having normal cardiac function survival probability of 95% or lower for a given blood heteroplasmy and gender and should be offered cardiac magnetic resonance (CMR) to better define the presence of and/or degree of LVH more accurately.37,38 Early introduction of a combination of angiotensin-converting enzyme inhibitor (ACE-I) and β-blocker for those with confirmed cardiomyopathy is advocated routinely by our centre, based on best practice cardiac guidelines.39 The gene discussed is ACE; the disease is cardiomyopathy.