Homozygous or compound heterozygous mutations in the ACADVL gene, however, have been described to cause deficiency of the very long-chain acyl-CoA dehydrogenase (VLCAD-deficiency, OMIM# 201475) leading to, among other, hypertrophic cardiomyopathy, sudden cardiac death, hepatomegaly, hypotonia and lethargy [16]. This evidence concerns the gene ACADL and hypertrophic cardiomyopathy.