Introduction. Double heart rupture is a rare complication of acute myocardial
infarction with high mortality. Case report. We presented a 67-year-old
female patient with symptoms and signs of myocardial infarction, diagnosed
with echocardiography, rupture of the septum, the presence of a thrombus and
a small pericardial effusion. Soon after admission the patient died. Autopsy
revealed tamponade and double myocardial rupture, free wall rupture and
ventricular septal rupture, as a cause of death. Conclusion. This case
highlights the need to evaluate patients with myocardial infarction,
recurrent chest pain, echocardiographic signs of effusion and the presence of
thrombus in the pericardium in terms of double rupture of the heart.