Current teaching is that fatty infiltration into the myocardium (lipomatosis or cor adiposum) rarely affects cardiac function. This may not be entirely true. Rupture during acute myocardial infarction has certainly been shown to be more common in the fatty heart.1 Fat infiltrating in the region of the conduction system is responsible for causing sudden death.2 Furthermore, it is possible for lipomatous hypertrophy in the heart to even undergo malignant transformation.3 Since fat is a normal constituent of the heart, it remains undefined as to exactly how much, and in which locations, one considers fatty …