Each year in the US alone, over one million individuals are diagnosed with an acute myocardial infarction (AMI) and approximately one half of these have had an AMI in the past. The incidence of congestive heart failure (CHF) is on the rise. It is the leading cause of hospitalization in those age 65 and older. Healthcare costs for cardiovascular disease (CVD), which includes coronary artery disease (CAD) and coronary heart disease (CHD) are more than $400 billion each year. Heart disease is currently the leading cause of death in the US. As many as 1% to 5% of patients with an AMI are misdiagnosed in the emergency department and are discharged. The laboratory's role is especially important in individuals with an AMI who present with AMI symptoms but have a nondiagnostic electrocardiogram (ECG).