The search for the Holy Grail in cardiology has been the ability to obtain high quality pictures of the coronary arteries without the need to enter the body. CAT scans are specialized x-rays that have been used to obtain images of many body parts. The ability of CAT scans to obtain pictures of the heart has been limited by one unique property of the heart that distinguishes it from any other organ in the body…it continuously moves! The latest generation of high speed x-ray imaging systems and computer processors now enable exactly this. Using “multiple slice, multiple detector” technology, external images of the beating heart of sufficiently high quality to be comparable to coronary angiograms can now be obtained. The latest generations of scanners obtain coronary CT angiograms (CCTA) that reliably show the level of plaque inside coronary arteries just like a cardiac catheterization, and so much more. The CCTA does all of this in a painless, 14 second examination that requires the patient to simply lie inside a hollow chamber and briefly hold their breath. The greatest value of the CCTA examinations is to exclude, or “rule-out” CHD. In patients with suspected coronary heart problems, the CCTA has nearly 100% accuracy in the ability to detect any level of plaque. Since nearly one out of three patients in the U.S who have a cardiac catheterization turn out to not have any serious blockages, a CCTA potentially could eliminate many of these unnecessary invasive catheterizations.