Figure 1: Multimodality imaging of a 59-year-old patient with hypertrophic cardiomyopathy with dystrophic calcification. (a) Apical 4C view suggestive of calcification at the apex of left ventricular involving papillary muscle. (b) PLAX view showing calcification involving papillary muscle with septal hypertrophy. (c) M mode transthoracic echocardiogram showing septal hypertrophy with normal left ventricular function. (d) Cardiac computed tomography suggestive of dystrophic calcification involving papillary muscles, left ventricular apex. (e) Cardiac computed tomography showing calcified lesions involving mid and distal right coronary artery. (f) Magnetic resonance imaging showed features suggestive of hypertrophic cardiomyopathy and features of noncompaction with apical area showing mixture of thrombus and calcification. (g and h) Coronary angiogram suggestive of 90%–95% calcified stenosis in the mid-right coronary artery with calcification at the left ventricular apex. (i and j) Intravascular ultrasound showing a mixture of calcification with organized thrombus in the mid-right coronary artery.