In the event of a “high risk” exercise treadmill test, subjects will be offered inpatient admission. High risk tests will include any of the following: the occurrence of sustained ventricular tachycardia, syncope, a high risk Duke treadmill score (>-10), limiting angina in stage 1 of the Full Bruce protocol, > 2 mm ST depression in 3 or more leads in stage 1 of the Full Bruce protocol. Subjects with such high risk tests who are assigned to the “no coronary MSCT angiography” arm will be encouraged to undergo invasive coronary angiography. Subjects assigned to the “mandatory coronary MSCT angiography” arm will undergo coronary MSCT angiography in an expedited manner. This will be followed by invasive coronary angiography, if warranted, 48 hours later. Because the protocol excludes subjects deemed as having a high pretest probability of obstructive coronary artery disease, the potential for this occurrence should be minimized.