We have never had a symptoms-based guideline before. Why was it time for these new Chest Pain Guidelines? How does shared decision-making come into the assessment of chest pain? Is anatomic or functional testing preferred in the evaluation or acute chest pain or stable chest pain? In this interview, Martha Gulati MD MS FACC FAHA FASPC FESC and Christopher M. Kramer MD, FACC, with Nosheen Reza MD, discuss the top controversies behind the Chest Pain Guideines.