Abstract
1. 1. Three personally observed cases of perforation of the interventricular septum following myocardial infarction were presented. One of these patients has lived six years and six months after her infarction and perforation. We believe this to be longer than any previously reported survival with this disorder. 2. 2. Criteria for the diagnosis of perforation of the infarcted interventricular septum are: (a) presence of recent myocardial infarction, (b) sudden appearance soon after infarction of a harsh systolic murmur and thrill at the lower left sternal border, and (c) the rapid worsening of the condition of the patient at the time the murmur appears. 3. 3. The differential between this condition and rupture of the infarcted papillary muscle was discussed. This is the only condition which might easily be confused with perforation of the septum. 4. 4. Factors thought to be contributory to myocardial rupture were presented.
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