I often encounter such patients in the clinic, about 50 years old for various reasons to do an electrocardiogram, suggesting that there are ST-segment or T-wave changes, combined with the usual symptoms of occasional chest pain and tightness, the doctor diagnosed as “coronary heart disease”, “myocardial ischemia” and so on. And so on, long-term oral aspirin, ginkgo biloba, etc., this hat is worn for decades, long-term medication not to mention, but also carry a great deal of psychological pressure, and often decades later to the hospital imaging confirmed that there is no coronary stenosis, such examples are not a few, the lesson is also profound. With the development of medicine, there are more and more tests about coronary artery disease, such as echocardiography, plate motion test, nuclear myocardial perfusion test (SPECT or PET), cardiac MRI and other tests, but the only tests that can really rule out coronary artery disease are percutaneous coronary angiography (CAG) and coronary CT examination. The former is the “gold standard” for the diagnosis of coronary artery disease, but it is not routinely performed because of its invasive nature and surgical risks. Therefore, coronary CT is currently the only effective clinical tool to exclude the diagnosis of coronary artery disease. Several international large-scale randomized double-blind studies have confirmed that the negative predictive value of coronary CT for the diagnosis of coronary artery disease is as high as 99%, which means that if you do not have coronary artery disease, there is a 99% chance that you do not have coronary artery disease, and the accuracy is very high. Therefore, as a patient with suspected coronary artery disease diagnosed by ECG, ultrasound or medical history, coronary CT examination is the best choice!