A 56-year-old man died suddenly at Yale-New Haven Hospital six weeks after experiencing a myocardial infarct and subsequent left ventricle aneurysm formation. Clinical course, treatment, radiologic data, and pathologic findings are examined. Differential diagnosis for this patient's sudden demise include cardiac rupture with cardiac tamponade, extension of the myocardial infarct, and massive pulmonary embolus, among others.