An ischemia detecting system has an implantable medical device connectable to an LV cardiac catheter with sensors for generating sensor signals representative of the concentration of a constituent in coronary venous blood at different sites in the coronary venous system. The sensor signals are co-processed by the system to detect an ischemic region of the subjects heart based on a relation between the sensor signals. The detection of the particular ischemic cardiac region is possible by conducting the concentration monitoring on either sides of a branching vein in the coronary venous system and co-processing the sensor signals.