The article presents an overview of the problem of fat deposition in the myocardium. Morphological characteristics, clinical and noninvasive imaging techniques, such as echocardiography, multislice computed tomography and magnetic resonance imaging of the heart are presented in the article. Different forms of fat deposits as lipomatose dysplasia after myocardial infarction, arrhythmogenic right ventricular dysplasia, heart lypoma, lipomatose hypertrophy of the interatrial septum, and physiological fat deposition are described. Article is illustrated with original images of various forms of fat deposition in the heart. The clinical case of lipomatose hypertrophy of right ventricle in 55 years old patient with complaints of dyspnea on exertion is presented. During echocardiography unusual thickening and changes of the right ventricular wall structure were found. The diagnosis was confirmed by contrast cardiac MSCT. The patient had also ESC abnormalities. Further observation of patients with so-called physiological adipose tissue of myocardium is necessary in order to evaluate its clinical value and long-term prognosis.