The purpose of this paper is to inform the case of a 15 years old male patient who died as a consequence of acquired immunodeficiency syndrome (AIDS) complications. The postmortem examination showed a coronary lesion which, to the best of our knowledge, has not been previously described. This vasculopathy was restricted to the coronary arteries; myocardial changes similar to those described in AIDS-associated dilated cardiomyopathy were also present. The coronariopathy was indistinguishable from that described in the blood vessels of the brain in patients with AIDS-related cerebral arteriopathy. We also reviewed the autopsy material from another 14 children who died of AIDS, an in none of them exhibited similar changes in the coronary arteries. In addition we present the clinical findings and some theoretical considerations regarding the pathogenesis of the lesions.