We report the case of a 47-year-old man, referred for chest pain radiating to jaws associated with sweating. At coronary angiography, left anterior descending coronary artery was occluded with distal perfusion by collateral flow, and proximal coronary aneurysms involving proximal left circumflex (LCX) right coronary artery with diffuse coronary atherosclerosis were present. Coronary thrombosis was also present into LCX proximal aneurysm.