Acute Ventricular Septal defect (VSD) complicating acute inferior myocardial infarction is an unusual and frequently lethal complication of myocardial infarction. Often, the infarct is not unusually large and the defect is caused by normally contracting myocardium shearing away from adjacent myocardium that is significantly necrotic. In this case, we discuss the clinical course, management, and anticipated outcomes of a young man with an acute VSD.

Note: This course is eligible for ACPE credit.

• To recognize the clinical significance of cardiac murmur in the setting of a patient who may have had a recent acute myocardial infarction
• To identify the hemodynamic profiles that are associated with adverse outcomes
• To describe the considerations regarding optimal timing of cardiac surgery for acute VSD complicating myocardial infarction