Embodiments of the invention are related to devices and methods for myocardial ischemia detection, amongst other things. In an embodiment, the invention includes an implantable medical device including control circuitry, an electrical field sensor in communication with the control circuitry, the electrical field sensor configured to generate a signal corresponding to cardiac electrical fields. The implantable medical device can also include a chemical sensor in communication with the control circuitry, the chemical sensor configured to generate a signal corresponding to the concentration of a physiological analyte that affects cardiac electrical field waveform morphology. The control circuitry can be configured to monitor for the presence of myocardial ischemia by evaluating both the signal generated by the electrical field sensor and the signal generated by the chemical sensor. Other embodiments are also included herein.