LVNC has gained increasing recognition in the last 30 years, and there has been some discussion of its terminology and definition. 4 Our case fulfilled the morphological definition of LVNC, although there may be some suspicion that this structure really represents an arrest of the myocardial compaction process during the first trimester. Oechslin and Jenni4 described that multiple persistent sinusoids are generally present with pulmonary artery atresia and that these patients should not be included the category of LVNC. Unlike the Oechslin and Jenni report, the patient described here did not have pulmonary atresia. Coexistence of hypertrophic cardiomyopathy and LVNC in one family with overlapping phenotypes has been reported. 3 A comprehensive diagnostic assessment, including multimodality imaging, systematic screening, and genetic assessment, may help elucidate the true cause of cases with multiple anomalies. To the best of our knowledge, this is the first report describing a patient with apical hypertrophic cardiomyopathy, multiple coronary artery–left ventricular fistulas, and a morphological structure mimicking LVNC.