A 60-year-old woman with a past medical history of hyperlipidemia and elevated diastolic blood pressure, presented with a two-month history of worsening intermittent palpitations, chest tightness, and diaphoresis. Electrocardiography revealed non-specific ST-T changes in the anterior leads; high-sensitivity troponin was normal. Based on intermediate pre-test probability per 2021 AHA/ACC Chest Pain Guidelines,1 coronary CT angiography (CTA) was performed for suspected coronary artery disease.