INTRODUCTIONLeft ventricular noncompaction cardiomyop-athy(LVNC)is a rare form of cardiomyopa-thy characterized by deep intertrabecular re-cesses and abnormal trabeculations that can be showed by transthoracic echocardiogram (TTE)or cardiac MRI(CMR). Our case de-scribed a 44-year-old male who presented with unclear speech,left limb weakness and was discovered to have significantly reduced left ventricular ejection fraction (LVEF) which was nonischemic in etiology as confirmed by cardiac catheterization. Subsequent evaluation with TTE and CMR imaging revealed noncom-paction of the left ventricle. The patient re-ceived cardiac resynchronization therapy-defi-brillation(CRT-D)implantation and anticoagu-lation given his elevated risk of heart failure, malignant arrhythmia and stroke. This case highlights the importance of considering un-conventional etiologies of cardiomyopathy when investigating new-onset stroke and heart failure as well as the necessity of life-saving measures such as anticoagulation and CRT-Dimplantation in view of ventricular heart dis-eases with embolism,heart failure and malig-nant arrhythmia.