The number of computed tomography (CT) scanners capable of imaging the coronary arteries is increasing exponentially in the Western world. Expectations are that CT coronary angiography (CTCA) will replace conventional angiography in many patients. However, there is hardly any evidence showing that multislice CT is better than conventional stress testing in selecting patients for coronary interventions. The high negative predictive value of CTCA may provide help for some patients who are very concerned about the presence of coronary artery disease. Chest pain, however, may be caused by myocarditis and coronary vasospasm and CTCA is not able to exclude these conditions. The future will show whether CTCA is able to depict the development of atherosclerosis in the arterial wall by serial examinations at a reduced radiation exposure...