Ranolazine for the Treatment of Chest Pain in HCM Patients

Inclusion Criteria: * Age 18 years or older * Left Ventricle wall thickness \>/= 15mm in the absence of other condition causing hypertrophy * Baseline Angina/Shortness of Breath Frequency of \> 2 episodes per week * Willing to provide informed consent Exclusion Criteria: * Severe stenotic valvular disease * Severe valvular regurgitation except mitral regurgitation due to systolic anterior motion * Significant (\>60% stenosis) coronary artery disease * Acute coronary syndrome within 30 days * Severe heart failure defined as LV systolic dysfunction with Ejection Fraction \<40% or NYHA class 4 symptoms * Severe renal impairment (glomerular filtration rate, \<30 mL/min/1.73 m2) * Moderate-severe hepatic impairment (Child-Pugh classes B and C) * Hospitalization for cardiac reason within 3 months of enrollment * Anticipated changes to treatment of HCM within study period, including medications, device implantation, or septal reduction therapies * Concomitant use of ketoconazole, macrolide antibiotics, and HIV protease inhibitors * Active myocarditis, pericarditis, or restrictive cardiomyopathy * Non-cardiac terminal illness with expected survival less than 6 months * Women who are of childbearing potential * Inability to perform or adhere to study protocol