CT-First for Chest Pain: The Anatomical Truth Machine. Commentary by Jonathon Leipsic, MD, published in Medscape.

With millions of patients presenting to the ER each year with chest pain, Dr. Jonathon Leipsic highlights the need to rethink traditional diagnostic pathways. Stress testing and invasive angiography are often slow, costly, and unnecessary as first steps.

In his recent Medscape commentary, Dr. Leipsic makes the case for coronary CT angiography (CCTA) as the frontline test providing rapid, noninvasive visualization of coronary anatomy to confirm or exclude CAD, guide therapy, and better select patients for invasive procedures.

Backed by a Class I, Level A recommendation in the ACC/AHA chest pain guidelines, a CT-first approach brings clarity earlier and sets the stage for advanced tools such as FFR-CT and AI-enabled plaque analysis across emergency care, cath labs, and prevention clinics.