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A 41 year old man presented with transient atypical chest pains and was noted to meet criteria for left ventricular hypertrophy on his ECG. He therefore was referred for transthoracic echocardiography, which suggested some features of apical hypertrophic cardiomyopathy. In order to clarify this diagnosis, he was referred for a cardiovascular magnetic resonance scan, which revealed the presence of extensive fine trabeculation over the endocardial surface of the left ventricular myocardium, sparing only the septum. This may reflect embryonic persistence of fine trabeculation or non-compaction, most pronounced in the apical area where the myocardium is thinned. Non-compaction, in younger individuals, has been associated with a malignant outcome, but there is a paucity of data to suggest whether non-compacted trabeculation such as this has any adverse outcome. Our patient remains asymptomatic.