Systemic lupus erythematosus is an autoimmune inflammatory disease of unknown etiology, the coronary lesions are extremely rare, and in particular the coronary aneurysms. We report a case of a coronary aneurysm of a patient diagnosed with Systemic lupus erythematosus who showed up at the emergency department suffering from a retro-sternal pain radiating to the jaws which he reported for 4 hours. An electrocardiogram was performed urgently and showed an offset of 2 mm in the inferior, right, basal and low lateral territories with a mirror V1, V2. The patient underwent coronary angiography which revealed an aneurysmal dilatation of the right coronary artery with multiple atheromatous aneurysms of different sizes without thrombi visualized in the lumen of the arteries. Coronary aneurysms are a fatal and has potentially fatal complications that should be considered in the diagnostic of systemic lupus erythematosus patients with cardiac symptoms as early detection may allow complete healing.