Rupture of the interventricular septum (MVP) as a complication of acute myocardial infarction is a rare event and associated with high mortality without timely surgical treatment. We present a case of a 68-year-old patient who had an acute myocardial infarc‑ tion with ST-segment elevation complicated by a rupture of MVP. In this article we discusse the difficulties of patient management with this pathology and the problem of choice of treatment tactics.