Acute chest pain (ACP) accounts for more than 7 million Emergency Department (ED) visits each year in the US [1]. Patient management initially relies on the estimated risk of short term cardiovascular (CV) adverse events [1]. While low-risk patients do not need further testing, it is still debated which non-invasive test should be used in intermediate-risk ones [1]. Preliminary evidence has raised doubts on the net clinical benefit of testing these patients [2,3]. Simultaneously, cardiac diagnostic tests contribute to emissions of air pollutants that are well known CV risk factors [4].