Inflammation of the vessel wall occurs in a number of disorders, including Kawasaki disease, Churg-Strauss syndrome, Behcet syndrome, rheumatoid arthritis, syphilis, tuberculosis, and autoimmunity to heat-shock protein 65.1–6 Dissections of coronary arteries are increasingly recognized as a cause of sudden cardiac death in apparently healthy individuals. Women are affected more frequently (85% of cases reported), and approximately 35% of coronary artery dissections occur < 3 months postpartum. Dissections most often occur in the left coronary artery system (approximately 75%), primarily the left main artery or left anterior descending (LAD) artery (approximately 80%).7–8 Eosinophilic infiltration of the coronary arteries has been described9as a limited form of Churg-Strauss syndrome in patients with a lifelong history of allergies to (often) numerous agents.10 Panarteritis nodosa (PAN), a medium-sized-vessel vasculitis, has been described as a cause of myocardial infarction and angina.3 However, PAN also involves, at the same time, arteries other than the coronary arteries. In most of the arterial inflammatory disorders, cystic necroses in the vessel wall can be found.11There have been numerous case reports12–16 on inflammatory alterations in coronary arteries as a cause of sudden cardiac death. Rarely, the affected coronary arteries develop aneurysms.17–18 Previously, cases of strictly isolated eosinophilic coronary arteritis have been reported9–10,19; however, these occurrences were preceded by signs or symptoms of allergy, asthma, and dyspnea. The causes of inflammatory diseases of the coronary arteries, as reported in the literature, are mainly PAN,3 Takayasu arteritis,20 and rheumatic disease.6 Giant cell arteritis affects persons > 50 years of age almost exclusively, and the disease risk is highest among those who are > 75 years of age.21Systemic inflammation is present in almost all patients with giant cell arteritis.22 Here, we report a case in which the patient had none of the alterations described as predisposing a person to spontaneous coronary dissection.