There is a group of rare but serious complications of acute myocardial infarction (AMI), including free wall rupture (FWR) and, less frequent, ventricular septal rupture (VSR). Urgent surgery combined with simultaneous CABG is usually a treatment of choice. We present a case of a 65-year-old male with AMI, who developed cardiogenic shock due to cardiac tamponade as a result of FWR. The patient was successfully resuscitated and operated. During postoperative treatment parasternal systolic murmur was audible and VSR diagnosis was confirmed. Three months after AMI the AMPLAZER Muscular VSD Occluder was successfully implanted. The follow-up period was uneventful.