The autopsy findings of a 74-year-old women who unexpectedly died are presented. She had suffered from polymyalgia but typical symptoms of temporal arteritis had been absent and tentative treatment with prednisone had not improved the polymyalgic pain. The autopsy revealed a generalized giant cell arteritis involving the left temporal artery, the left common carotid artery, the ascending aorta, a submucosal artery of the ileum and the left anterior descending branch of the coronary arteries. Histology showed typical granulomatous infiltrates including giant cells, followed by thrombotical occlusion of the coronary artery branch and subsequent myocardial infarction. Giant cell arteritis is a systemic vasculitis of aged subjects with predominant localisation in the cranial arteries, but occasional involvement of any type of visceral and peripheral arteries. Coronary involvement with sudden cardiac death is not a commen complication of giant cell arteritis but has occasionally been described in the literature.