Chest pain is a frequent emergency department presentation, and many of these patients have recently undergone some form of prior stress testing or even cardiac catheterization. Utilizing cardiac testing results can be challenging. Does a recent “normal” stress test mean that a chest pain patient doesn’t need an ED workup and admission? Does a “negative” or “normal” cardiac catheterization mean there are no vulnerable plaques present that put the patient at risk for ACS? How does the cardiac CT angiogram (CCTA) factor into this picture?