We see a certain similarity in the case of a patient with pathogenic VARS2 mutations c.643C>T (p.His215Tyr) and c.1354A>G (p.Met452Val) who presented with poor sucking at birth, poor motor activity, hyporeflexia, hypertonia, persistent pulmonary hypertension of the newborn (PPHN), metabolic acidosis, severe lactic acidosis, and hypertrophic cardiomyopathy (12). This evidence concerns the gene VARS2 and hypertrophic cardiomyopathy.