Papillary muscle rupture is one of the rare and potentially life-threatening complication usually following acute myocardial infarction (AMI). Acute papillary muscle rupture (PMR) results in severe mitral regurgitation rapidly progressing to florid pulmonary edema and cardiogenic shock. Without emergent surgical intervention, the mortality is extremely high. The management of STEMI patients in COVID 19 pandemic is difficult and challenging. We present an unusual case of 56 years old male who presented with acute inferior wall myocardial infarction (IWMI), underwent successful thrombolysis, developed reinfarction 5 days later complicated by acute postero-medial papillary muscle rupture (PPMR) leading to severe acute mitral regurgitation.