Non-compaction cardiomyopathy is a rare entity associated with complications such as heart failure, cardioembolic phenomena, arrhythmias, and sudden death. Etiology is not fully understood, but it has a genetic base. Its diagnosis is increasing due to the use of echocardiography and is characterized by the thickening of left ventricular wall with prominences and recesses with absence of compacted myocardium while 2 different layers can be distinguished: compacted myocardium and non-compaction myocardium (Fig. 1). On the color Doppler echocardiography blood flow can be seen flowing between such crypts without communication with the coronary system (Figs. 2 and 3) with the possibility of causing emboli.

Figure 1

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Figure 2

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Figure 3

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We are providing echocardiographic images of a 62-year-old woman with clinical signs of respiratory failure due to ARF in the ventricular dysfunction setting (Video).