Although gestational choriocarcinoma is a rapidly invasive malignancy, metastatic invasion of this tumor to the heart is rare. We report an unusual case of coronary embolism, which was caused by malignant trophoblasts from choriocarcinoma in a 26-year-old woman. The woman presented with classic symptoms of ischemic heart disease after having successfully undergone chemotherapeutic treatment for choriocarcinoma several months earlier. Thus, she was thought to have coronary heart disease or to have developed cardiotoxicity from antineoplastic drugs. This is the first report of this type of metastatic localization and tumor involvement in the heart and underscores the need for suspecting isolated metastases in uncommon sites in patients with choriocarcinoma.