EurekAlert! -- By relying solely on a patient’s clinical risk profile or the results of one imaging test when assessing patients with chest pain, physicians may be missing important, early signs of atherosclerotic disease and opportunities to intervene, according to new findings published in the November 10, 2009, issue of the Journal of the American College of Cardiology (JACC). The authors recommend adding coronary artery calcium score (CACS) testing in patients with a normal single-photon emission computed tomography (SPECT) scan to better identify those at high long-term risk for cardiac events, in whom an earlier focus on aggressive risk factor modification and other medical therapies may be beneficial.