The medical history is the cornerstone of the diagnosis of chest pain. In presence of angina like symptoms, the diagnosis of coronary artery disease must be assertained by rest and exercise ECG, eventually coupled with a stress echo or scintigraphy. Coronary angiography remains the ultimate diagnostic procedure despite recent advances in CT scan or MRI technologies. Beside symptomatic treatment aiming to reduce metabolic demand by medication or to improve revascularisation by surgery or percutaneous intervention, the actual therapeutic approach involves therapies aiming to stop atherosclerosis such as strict correction of coronary risk factors, use of statines, ACE inhibitors and antiplatelet agents.