The NM_000257.4(MYH7):c.4354-7C>T variant has been reported in 3 individuals with HCM (Invitae pers. comm; LMM pers. comm.). This variant has also been identified in 0.004% (FAF 95% CI; 4/34362) of Latino/Admixed American chromosomes by gnomAD v2.1.1 (https://gnomad.broadinstitute.org). Since the MYH7 specifications state that PS4 is only applicable if the variant is absent or rare in large population studies, the PS4 criterion was not applied (Kelly 2018 PMID:29300372). This variant is located in the 3' splice region and computational tools do not predict an impact on splicing, though this information is not predictive enough to rule out pathogenicity (BP4). In summary, due to insufficient evidence, this variant is classified as uncertain significance for hypertrophic cardiomyopathy in an autosomal dominant manner. MYH7-specific ACMG/AMP criteria applied (PMID:29300372): BP4.