A magnetocardiograph (MCG) is a device capable of recording of magnetic fields arising from the electrical activity of the heart with traces similar to an electrocardiogram (ECG). This system was developed as a noninvasive, non-contact diagnostics of obstructive coronary artery disease (CAD), and especially of lack of oxygen in the heart as in a heart attack. The overall objective of this study is to demonstrate the efficacy of this MCG device for the detection and diagnosis of lack of oxygen of the heart in patients with chest pain.

Coronary Artery Disease is the leading cause of death in the United States. The non invasive detection of Acute Coronary Syndromes (ACS's) remains a clinical challenge. Electrocardiogram (ECG) may only diagnose myocardial infarction in 50 % of the cases. Magnetocardiography is a new and noninvasive method capable of measuring and mapping the magnetic field that is generated during the cardiac cycle. The electric current is affected by ischemic damage, which in turn alters the magnetic field. The magnetic field is not affected by body tissues, unlike the surface current measurements in ECG.

Comparisons: The diagnostic accuracy of the CMI-Magnetocardiograph will be compared to that of the ECG in diagnosing High Risk Unstable Angina.

Inclusion criteria:

• Patients classified as having High Risk Unstable Angina according to the ACCIAHA guidelines.
• Age ≥ 18 years.

Exclusion criteria:

• Hemodynamically unstable patients.
• Patients who just prior to or just after admission exhibit tachycardia with heart rates exceeding 150 bpm.
• Patients with third degree AV Block.
• Patients with pacemakers or internal cardiac defibrillators.
• Patients who cannot lie in a supine position for the MCG examination.
• Patients who refuse entry into the registry

*ACC/AHA Guidelines for Unstable Angina: High Risk (≥1 of the following)

History

• Accelerating tempo of ischemic symptoms in the last 48 hrs Pain
• Prolonged, ongoing (>20 min) rest pain (resistant to treatment) Clinical findings
• Pulmonary edema
• New / ↑ MR murmur
• S3 or new/ ↑ rales
• Hypotension, brady -/tachycardia - Age>75y ECG
• Angina at rest with transient ST changes >0.05 mV
• New (L)BBB
• Sustained VT Cardiac Markers
• Markedly elevated troponin

Patients classified as having high-risk unstable angina at presentation in the ED will be approached for enrollment in the study.