 This multi-center, randomized, controlled trial conducted in Emergency Departments ED compares computed tomography CT coronary angiography with the traditional approach usual care for low- to intermediate-risk chest pain patients. The primary objective is to estimate the rate of major cardiac events heart attack or cardiac death within 30 days in trial participants in Group B who were not found to have significant coronary artery disease by CT coronary angiography. Additional evaluations will comprise health care utilization assessments, including length of hospital stay and re-admissions, cost analysis, and 1-year post-triagepresentation major cardiac event rates. 