Summary

1-If the patient has symptoms such as angina, look to the ECG and cardiac markers.

2-If they are showing abnormalities which increase incidence of presence of narrowing,  patient is preferred to subject him directly to conventional coronary angiography. When you have angina and  a positive MSCT, the chance of you having significant coronary narrowing has a sensitivity of 97% and specificity of 86% which is very low to depend upon it.

3-If the patient does not have ECG changes or elevated cardiac markers, it is preferred to subjects the patient to stress testing with or without imaging such as multi slice CT angiography.