Aims: To discuss the diagnosis of giant coronary aneurysms.
Methods and results: We describe three patients in whom initial echocardiographic findings suggested cardiac tumors in the right atrium. Additional examination proved the tumor-like structures to be giant atherosclerotic coronary aneurysms of either the right coronary artery or its saphenous vein coronary bypass graft.
Conclusion: Giant coronary aneurysms are an important differential diagnosis for cardiac tumors.