The paper comparatively analyzes myocardial morphology in children and adults with hypertrophic cardiomyopathy. All the cases analyzed had its obstructive form and significant asymmetric left ventricular hypertrophy - hypertrophy of the ventricular septum (VS). When stratifying the risk of sudden death from the obstructive form of the disease in adults, the most important characteristics are shown to be less than 45 years of age, stromal enlargement in the right VS closer to the endocardium of the right ventricle; and in some cases this fact must be considered when choosing a management tactic.