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The authors present the case of a 47-year-old man, with hypertension and dyslipidemia as cardiovascular risk factors, who had come to the emergency department in 2008 for chest pain. Diagnostic exams at that time (ECG and cardiac biomarkers) revealed no signs of acute ischemia, but exercise testing was positive for myocardial ischemia. Invasive coronary angiography was performed, which showed no angiographically significant coronary lesions. He subsequently underwent myocardial perfusion scintigraphy, which revealed no evidence of ischemia. Due to persistence of symptoms, in 2012 exercise testing was repeated, which was positive for ischemia. In order to clarify the clinical picture, he was referred to our hospital for cardiac computed tomography (CT) angiography. This showed a zero calcium score (Figure 1), corresponding to the 25th percentile for age and gender, and revealed 50--70% stenosis with a non-calcified eccentric plaque in the distal left main/proximal anterior descending artery (Figure 2). Invasive coronary angiography confirmed significant coronary artery disease (Figure 3) and the patient was referred

Contributo da angio tomografia computorizada cardíaca na avaliação da dor torácica