A 62 year old woman presented with recurrent episodes of amarosis fugax and headache. She had a past medical history of well controlled essential hypertension, and had been treated for pulmonary tuberculosis two years previously. A routine transthoracic echocardiogram revealed an abnormal left ventricle, with mid cavity thickening giving the appearance of a smaller chamber adjacent to the main left ventricular chamber. Two dimensional pulse wave Doppler demonstrated dynamic flow acceleration in mid cavity. Cardiac catheterisation revealed normal coronary arteries and confirmed mid cavity hypertrophic cardiomyopathy. An intraventricular gradient of 60 mm Hg was demonstrated between the two cavities. A 16 slice multidetector computed tomographic (MDCT) scan was performed following injection of 120 ml of non-iodinated contrast; axial images are shown in panel A. Following acquisition, three dimensional reconstruction was performed offline on a GE workstation to generate a 3D image of the ventricular structure (panel B).