We report the case of a 69-year-old patient with no history of cardiac problems referred to us for dyspnea. A major systolic murmur was found and the echocardiogram revealed an interventricular septal defect. The ECG showed no signs of acute myocardial infarction that was established on the basis of myocardial enzymes. The patient was hemodynamically stabilized by intra-aortic balloon pumping. A later coronarography revealed one-vessel coronary artery disease. Then the patient underwent successful surgical repair of the septal defect.