The hx suggest HOCM, but the ECHO is normal. The ECG only shows an R in V1, which may not be significant. With the hx, the pt needs further investigation with a stress ECG followed by a Holter. May have sick-sinus syndrome or a WPW as one can imagine a delta wave in some leads.
There is a small delta wave, but i'm not really sure about WPW i don't see Brugada here. sokolow-lyon is < than 35mm so i don't think it's LVH, but echocardio could be useful
Both the EKG and echo have ruled out cardiomyopathy. I would still evaluate for anemia, hypothyroidism, etc. but my greatest concern is ruled out.