Cardiac CT offers an anatomic evaluation to identify the presence of CAD. The modality has been identified as a class IIa recommendation for patients presenting with chest pain to rule-out acute coronary syndrome in patients with normal ECG, normal troponin and no previous history of CAD. CT is a great addition to a chest pain pathway protocol for quick rule-out in an emergency room setting to potentially help decrease length of stay and improve the definitive rule-out diagnosis. Patients appreciate the short turn-around and the modality has been found to be cost-effective compared to traditional chest pain evaluations.⁶