Decreased scintigraphic perfusion imaging is the most widely used non-invasive modality for the detection of myocardial ischaemia, but scintigraphic assessment of myocardial ischaemia is sometimes difficult in hypertrophic cardiomyopathy owing to inhomogeneous hypertrophy of the left ventricular wall. A technique that combines exercise testing and positron emission tomography with [¹⁸F]fluorodeoxyglucose was performed in a patient with non-obstructive hypertrophic cardiomyopathy showing asymmetrical septal hypertrophy. The images obtained clearly showed increased uptake of [¹⁸F]fluorodeoxyglucose in the interventricular septum, especially predominant …