Introduccion: el ventriculo izquierdo no compactado (VINC) es una entidad rara, de origen genetico, caracterizada por la presencia de trabeculaciones miocardicas, debidas probablemente a detencion de la embriogenesis endomiocardica. Caso clinico: varon de 33 anos de edad, sin antecedentes patologicos, quien dos meses antes comenzo a presentar disnea progresiva hasta llegar a disnea de reposo y ortopnea. Al examen fisico se encontro taquipnea, taquicardia, galope izquierdo por S3 y crepitantes en bases pulmonares. El electrocardiograma mostro taquicardia sinusal y cambios inespecificos difusos ST-T. En la radiografia de torax se observo cardiomegalia y signos de congestion pulmonar. Con el ecocardiograma se confirmo presencia de ventriculo izquierdo severamente dilatado con multiples trabeculaciones y recesos intertrabeculares. En el Holter cardiaco de 24 horas se reporto: ritmo sinusal, extrasistolia ventricular monomorfica aislada, frecuente, con episodio de taquicardia ventricular monomorfica no sostenida. Conclusion: las manifestaciones clinicas, gravedad y edad de comienzo de los sintomas del VINC son variables. Se debe hacer diagnostico diferencial con otras patologias mas comunes, especialmente la cardiomiopatia hipertrofica y dilatada. Rev.cienc.biomed. 2013;4(2):358-362 PALABRAS CLAVES Cardiomiopatia dilatada; Cardiologia; Insuficiencia cardiaca; Ventriculos cardiacos. SUMMARY Introduction: left ventricular noncompaction (LVNC) is a rare disease with genetic origin, characterized by the presence of numerous myocardial trabeculations probably due to a detention of the normal process of the endomyocardial embryogenesis. Clinical case: 33 years-of-age man without pathological history, which had been presented progressive dyspnea, dyspnea at rest and orthopnea since two months ago. At physical examination, the patient had tachypnea, tachycardia, S3 left ventricular gallop and crackles in the bases of the lungs. The electrocardiogram showed sinus tachycardia and unspecified diffuse changes of ST-T. The thoracic radiography displayed cardiomegaly and signs of pulmonary congestion. Color doppler echocardiography revealed left ventricle severely dilated with multiple trabeculations and intertrabecular spaces. Ambulatory electrocardiography for 24 hours reported sinus rhythm, frequent isolated monomorphic ventricular extrasystoles with episode of monomorphic no supported ventricular tachycardia. Conclusion : the clinical manifestations, seriousness and the age of beginning of the symptoms of the LVNC are variable. The differential diagnosis must be done with other common pathologies, especially with hypertrophic cardiomyopathy and dilated cardiomyopathy. Rev.cienc.biomed. 2013;4(2):358-362 KEYWORDS Cardiomyopathy dilated; Cardiology; Heart failure; Heart ventricles