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left ventricular noncompaction (lvnc), or "spongy" cardiomyopathy, is a recently described and recognized finding with important prognostic implications. it is characterized by the presence of ventricular trabeculations and deep intertrabecular recesses on the endocavitary side, leading to hypertrabeculation. although the etiology is unknown, a significant family aggregation of this disease as well as overlap with other genetic cardiomyopathies such as dilated cardiomyopathy and hypertrophic cardiomyopathy have been described. from the clinical point of view, lvnc often presents as heart failure, but may present with sudden death, arrhythmias and systemic embolism. at the present time the most useful diagnostic tool is transthoracic echocardiography because of its lower cost, reproducibility and availability, though cardiac magnetic resonance (cmr) imaging has shown greater diagnostic accuracy. treatment of these patients is no different than that recommended for patients with heart failure syndromes of other etiologies. (acta med colomb 2011; 36: 187-195)