When you arrive at the Emergency Department with chest pain, your doctor evaluates three main body systems: the heart, the lungs, and the gastrointestinal tract. The first tests are typically an ECG and bloodwork (including troponin), often followed by a chest X-ray. If a heart attack is suspected, you may be sent directly to the cath lab. Additional imaging — such as a CT angiogram — is reserved for higher-risk presentations like suspected pulmonary embolism or aortic dissection.