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INTRODUCTION: Despite the significant reduction in mortality from acute infarcts over the past decades thanks to monitored medical treatment and early reperfusion, a considerable hospital mortality rate persists. This is the consequence of refractory ventricular failure in the majority of cases, or of mechanical complications of the infarction. Mechanical complications include interventricular communication on septal rupture, tamponade on rupture of the free wall of the left ventricle, and acute mitral insufficiency on infarction or rupture of the papillary muscle. While these complications are rare, they have a very poor prognosis. This is why it is very important to know the clinical manifestations so as to clarify the diagnosis by echocardiography and allow urgent medical and surgical management. Interventricular communication (VIC) is caused by a rupture of the interventricular septum. It occurs in less than 0.5% of all STEMI, typically three to five days after an ischemic episode which is most often inaugural and extensive. The main risk factors for postinfarction VIC are advanced age, lack of revascularization and female sex. Over 70% of patients with postinfarction VIC die in hospital, and over 90% within one year. RESULT: Our patient presented with an anginal recurrence of infractoid chest pain with stage III dyspnea of NYHA with on the ECG a persistent elevation of the ST segment in the anteroseptoapical and negative T waves in the extended anterior, on the ETT LV dysfunction with disturbed segmental kinetics, estimated LVEF of 20%, enormous aneurysm of the apex and adjacent segments, and restrictive muscle VIC. Due to the hemodynamic stability, the patient underwent postponed surgery for 6 weeks. CONCLUSION: The association of VIC and LV infarction is a rare entity and usually occurs within two weeks of an MI. However, and what is the case with our patient, these complications can occur several weeks later. Rapid diagnosis and urgent surgical management significantly improve patient prognosis