Summary: In 2019 the European Society of Cardiology (ESC) announced new guidelines for the diagnosis and management of chronic coronary syndromes. The new guidelines bring new light to coronary syndromes with a surprising change in nomenclature. The previously used term “stable coronary syndromes” has been changed to “chronic coronary syndromes” (CCS) in order to emphasize that coronary artery disease is a dynamic process and can become unstable at any time. The ESC also provided a six-step approach for the initial diagnostic management of patients with angina. The first and most important step is to differentiate between acute and chronic coronary syndromes. It determines further proceedings and the time to initiate them. Following the exclusion of ACS, assessing symptoms, considering comorbidities and life quality, performing basic tests and assessing pre-test probability an appropriate testing (both specific and safe) needs to be selected. The new guidelines emphasize the role of coronary CTA in symptomatic patients in whom obstructive coronary artery disease (CAD) cannot be excluded by clinical assessment alone. Early diagnosis and instant application of effective therapy along with lifestyle change is necessary to reduce mortality and improve the life quality of individual patients as well as the whole population.