A rare case of isolated left ventricular non-compaction. Importance of image technology and disease awareness for a correct diagnosis

In 1999 a 50-year-old man with sustained monomorphic ventricular tachycardia came to our institution for investigation using fundamental echocardiographic imaging. A diagnosis of hypertrophic cardiomyopathy with dilatation and apical thrombus was made. In 2003, a new echocardiographic machine equipped with second harmonic imaging modality became available and after a second investigation the diagnosis was changed to isolated left ventricular non-compaction. The echocardiogram showed hypertrabeculations involving not only the mid-septum but also the basal septum (anterior and posterior) and a thin epicardial layer without the thickened endocardial component.