Myocardial rupture complicated acute myocardial infarction in a 50 year old man. Resuscitation was started immediately and he was treated with pericardiocentesis and a massive intravascular infusion of fluid. The torn area was plicated with Teflon felt and reinforced with an uninterrupted suture. The postoperative course was uncomplicated. This report points out the crucial importance of prompt clinical recognition and management of the acute stage of cardiac rupture in acute myocardial infarction.