This example shows 3D-perfusion-CMR in a 75-year-old man presenting with angina. Stress-induced perfusion defects are seen infero-laterally from base to apex and antero-laterally from mid-ventricle to apex in both diastole and systole. However, perfusion defects are difficult to discern from dark-rim artifact in diastole and are more clearly delineated with systolic acquisition. Late-gadolinium enhancement imaging did not reveal any previous myocardial infarction. X-ray coronary angiography revealed 80% stenosis of a large diagonal branch and significant proximal disease in a large dominant left circumflex artery.