A patient with chest pain and inferoseptal ischemia at Rubidium-82 Positron Emission Tomography (82RbPET) was revascularized in a stenosis in the LAD/D1 bifurcation, while a CTO RCA was left untreated. One-year follow-up with Seattle Angina Questionnaire and repeat 82RbPET revealed symptom relief and improved inferoseptal perfusion likely through LAD collateralization.