Left ventricular non-compaction (LVNC) cardiomyopathy is a relatively novel cardiomyopathy that is characterized by increased left ventricular trabeculation and inter-trabecular recesses communicating with the left ventricular cavity. The disease is rare amongst Caucasians but studies in heart failure patients of African/Afro-Caribbean origin (black) demonstrate that a high proportion fulfil criteria for LVNC [ [1] Kohli S.K. Pantazis A.A. Shah J.S. et al. Diagnosis of left-ventricular non-compaction in patients with left-ventricular systolic dysfunction: time for a reappraisal of diagnostic criteria?. Eur Heart J. 2008; 29: 89-95 Crossref PubMed Scopus (337) Google Scholar ]. Recent observations in athletes have also demonstrated a 3-fold greater prevalence of increased LV trabeculation amongst black athletes compared with Caucasian athletes, with almost 15% fulfilling echocardiographic LVNC criteria [ [2] Gati S. Chandra N. Bennett R.L. et al. Increased left ventricular trabeculation in highly trained athletes: do we need more stringent criteria for the diagnosis of left ventricular non-compaction in athletes?. Heart. 2013; PubMed Google Scholar ]. Given the high prevalence of LVNC compared with other primary cardiomyopathies implicated in the general population, it is unclear whether the myocardial morphology observed in black individuals is representative of LVNC or merely an epiphenomenon associated with increased cardiac preload. Chronic anaemia of sickle cell disease is associated with an increased LV preload and a high cardiac output. Although published data describing the cardiovascular adaptation in patients with sickle cell anaemia [ [3] Gladwin M.T. Sachdev V. Cardiovascular abnormalities in sickle cell disease. J Am Coll Cardiol. 2012; 59: 1123-1133 Abstract Full Text Full Text PDF PubMed Scopus (155) Google Scholar ] include LV dilatation and eccentric hypertrophy, the co-existence of increased LV trabeculation or indeed, the presence of LVNC criteria has not been reported. The issue is pertinent since dyspnoea and chest pain are common to both sickle cell anaemia and LVNC.