Kugel’s Artery as a Rare Intracoronary Collateralization Does Not Effectively Guarantee the Presence of Viable Hibernating Myocardium

In this note, it was aimed to describe a 66-year-old patient for ischemia evaluation following the episodes of chest discomfort using dipyridamole stress-rest myocardial perfusion single-photon emission computed tomography (SPECT). Invasive coronary angiography demonstrated a total occlusion of the right coronary artery (RCA) and prominent RCA intracoronary collateral (Kugel’s artery) associated with nonviable, infarcted myocardium in the inferior wall of left ventricular LV on myocardial perfusion SPECT. Thus, recanalization of RCA was not performed in our patient. It is concluded that performing complementary imaging modalities for assessing myocardial perfusion like SPECT for the prediction of viability to sole reliance on angiographic data in decision making for revascularization is encouraged.