Abstract: A patient hospitalized with palpitation, chest tightness, and shortness of breath was reported in this study. She was definitively diagnosed with Graves' hyperthyroidism and had several risk factors of coronary heart disease (CHD), including old age, hypertension, diabetes, and hyperlipidemia. Resting and ATP stressing myocardial perfusion imaging were applied in 2 days to determine whether CHD exists in this patient. Results confirmed that the patient has extensive myocardial ischemia and a high risk of cardiac adverse events. Thus, coronary angiography was suggested. Revascularization was achieved after percutaneouscoronary intervention, and no hyperthyroidism crisis occurred. MPI is recommended for patients with hyperthyroidism and suspected CHD after excluding correlative contraindications to facilitate the risk stratification of CHD and guide further treatment strategies.