Coronary artery disease (CAD) is a silent killer that may go undetected for years. It is the leading cause of death with no limitation to geographic boundaries accounting to about 16.7 million deaths world wide. Different studies have shown that South Asians populations are more prone to CAD where it is emerging as an epidemic. According to a study conducted in Karachi it is estimated that the overall prevalence of cardiovascular diseases in Pakistan is 26.9% with 23.7% in men and 30.0% in women. However tools for measuring CAD have not being adequately validated. This study is designed to develop screening tools and to determine test characteristics of Rose Questionnaire and Minnesota Coded ECG alone and in combination for diagnosis of CAD, using MPI as gold standard in Pakistan.