Ventricular septal defect (VSD) and papillary muscle rupture are severe complications of myocardial infarction which are usually observed individually although their simultaneous occurrence has been observed in pathological studies. An 82-year-old female underwent repair of a post-infarction VSD and 13 days later required mitral valve replacement due to delayed papillary muscle rupture. Mechanical complications of myocardial infarction can occur in the same patient even in delayed fashion and a two-stage correction may be successfully accomplished.
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