Abstract
Clinical case of an 86-year-old male patient presenting with a late anterior myocardial infarction without reperfusion is reported. Initial echocardiographic assessment revealed a rare and complex mechanical complication: intramyocardial dissection of the left ventricular apex associated with interventricular septal rupture. Given the severity of the condition, an urgent surgical intervention was undertaken using a bovine pericardial patch. Although the initial postoperative course was favourable, multiple subsequent complications ultimately led to the patient's death from ventricular arrhythmia on day 50th of hospitalisation. This report underscores the importance of timely diagnosis and multidisciplinary management of this rare clinical entity.