Chest pain is one of the major reasons for adults to seek medical advice, and even though most of the time the cause of chest pain is non-cardiac, acute coronary syndrome (ACS) and pulmonary embolism (PE) are considered the two main cardiovascular emergencies that must be recognized correctly and treated promptly. According to the most recent guidelines, both in the assessment of ACS and PE, computed tomography angiography (CTA) plays a key role, respectively in the form of coronary-CTA (CCTA) and pulmonary-CTA (CTPA). Due to the central role of CTA in the diagnosis of these conditions, it is mandatory to know how to execute angiographic protocols in order to obtain images that may help to detect endoluminal filling defects in pulmonary arteries and signs of right ventricle dysfunction in PE, whereas for ACS is necessary to exclude significant coronary stenosis. In addition, other diagnostic tools as dual-energy-CT (DECT) or cardiac MRI, might be helpful in confirming the suspect or in considering other diagnoses.