Giant coronary artery aneurysms and myocardial infarction in a patient with systemic lupus erythematosus.

A 26-year-old woman with systemic lupus erythematosus and end-stage renal disease presented for renal transplantation. She had no findings of cardiac disease. Radiologic evaluation, cardiac magnetic resonance imaging, and coronary angiography showed giant aneurysms of the right and left anterior descending coronary arteries. Despite therapy, acute anterior myocardial infarction developed during follow-up. Giant coronary artery aneurysms associated with systemic lupus erythematosus are unusual and their management is controversial. Antithrombotic therapy probably should be considered for giant coronary artery aneurysms.