 Despite spending 12 billion annually on the emergency evaluation of chest pain in the US, only 15 of admitted patients have a cardiac cause of their presenting symptoms. Clinical decision units CDUs improve resource utilization and are a recommended care option by the American College of Cardiology American Heart Association, but are underutilized in non-low risk chest pain patients due to weaknesses of traditional cardiac testing. Cardiac magnetic resonance imaging CMR is sensitive and specific for ischemia, can simultaneously assess cardiac function and myocardial perfusion, and could revolutionize the diagnostic process for intermediate risk patients with chest pain. The superior accuracy of CMR could decrease testing and invasive procedures. The high sensitivity for ongoing ischemia could allow imaging in parallel with cardiac markers. As a result, CMR could improve the care of emergency department ED patients with intermediate risk chest pain. However, the efficiency and safety of CMR has not been extensively tested in the CDU setting. 