 Background Coronary artery ectasia or CAE is defined as an inappropriate diffuse or localized non obstructive lesions of an epicardial coronary artery with a luminal dilatation more than the largest diameter of normal vessel more than diameter 1.5-fold [1.2.3.17.27]. Rheumatoid diseases are due to an immune inflammation maying touch several systems with frequent cardiovascular consequences maying include perimyocarditis, valvular diseases, coronary artery disease, and even heart failure more or less preserved ejection fraction, pulmonary hypertension, aneurysms and thrombosis. [4]  Materials / Methods We report here a case of a 61 year old moroccan female poor followed patient with hypertension, who was admitted to our hospital with acute coronary syndrome and has shown diffuse CAE (coronary arteries ectasia) of the three vessels TYPE I of Markis Classification. The rheumatoid arthritis was suspected and diagnosed during hospitalization and the treatment began.  Findings Even Arthritis (RA) is defined as a chronic, inflammatory, autoimmune disease, with unknown etiology, beside an insidious joint damage, leading to limited activities for the majority of. Furthermore, RA can be responsible of systemic complications and early mortality [18.28]. Rarely, the RA is diagnosed after cardiac complications. The coronary CT angiography was performed and revealed significant diffused coronary artery ectasia interesting the three vessels classified TYPE I of Markis Classification secondary to late diagnosis of rheumatoid arthritis [19].  Conclusions Atherosclerosis is considered as the principal etiology for more than 50% of coronary ateries ectasia adult cases[2.15]. Certainly Rheumatoid arthritis (RA) is a common inflammatory auto- immune disorder of the joints that affects almost 1% of the population and affects apart from synovial extra articular tissus such as vasculitis, lung disease, and cardiac complications, which include among other pericarditis, myocarditis, valvular affestion ,ischemic heart disease including coronary artery ectasia and heart failure.

Keywords : Coronary Artery Ectasia; Rheumatoid Polyarthritis; Acute Coronary Syndrome; Case Report.