A 44-year-old man with obesity and hypertension presented with dyspnea and cough during the coronavirus disease 2019 (COVID-19) pandemic. He was hypoxic and tested positive for COVID-19. Electrocardiogram showed sinus tachycardia with anteroseptal infarct of unknown age ( Fig. 1A ). Computed tomography (CT) showed multifocal pneumonia ( Fig. 1B ). Troponin was 0.09 ng/mL (peak 0.12 ng/mL). A systolic murmur was heard, and echocardiogram showed decreased ejection fraction, left ventricular (LV) aneurysm, pericardial effusion, and a ventricular septal defect (VSD) with left-to-right shunt ( Fig. 1C , Video 1 ). Cardiac magnetic resonance imaging and CT ( Fig. 1 D–F, Video 2 ) showed infarction of the mid to apical septum and the LV apex, with pericardial effusion, apical aneurysm, and restrictive VSD with Qp/Qs of 2.2. The VSD was too large for percutaneous closure. After discussion, the heart team decided to postpone the surgery until after resolution of the COVID-19-related pneumonia. Pre-operative left heart catheterization showed occluded left anterior descending (LAD) artery and left-to-right shunt on ventriculography ( Fig. 1G , Video 3 ). Finally, two months after initial presentation, the patient received bovine pericardial patch repair of the VSD ( Fig. 1H ), and LV aneurysm resection and LV reconstruction with the Dor procedure ( Fig. 1 I–J, Video 4 ).