Inferior MI in a 61-year-old woman who developed shortness of breath. Echocardiogram (not shown) depicted an ischemic ventricular septal defect in the location of a prior MI, and the patient was referred for cardiac MRI for further evaluation. Short-axis image from SSFP cine MRI shows an ischemic ventricular septal defect (arrow) between the left and right ventricles at the site of the MI. Supplemental MRI cine clips of the short axis and left ventricular outflow show a flow jet from the LV into the right ventricle through the ischemic ventricular septal defect (Movies 1, 2).