Impending myocardial rupture: is an early surgical treatment enough?

A 53-year-old man with a high-risk cardiovascular profile presented to the emergency department for a subacute myocardial infarction with signs and symptoms suggesting impending myocardial rupture. The case seemed to be resolved by an early successful surgical intervention. At 6-month follow-up, after repeated cycles of cardiac rehabilitation, the echocardiography revealed a pseudo-aneurysm of the apex and a left-to-right shunt through an inter-ventricular septum defect. The patient needed a new surgical intervention to repair this unexpected complication.