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Cardiovascular stress test imaging assists in the diagnosis and monitoring of cardiovascular disease. The procedure can be carried out in a magnetic resonance (MR) scanner using pharmacological agents that mimic the effects of natural exercise. In order to provide real time indication of ischemia, thereby assisting in diagnosis and helping to assure patient safety, it is desirable to have real time monitoring of the myocardial regional function. This paper presents an algorithm for the real time myocardium region-of-interest reconstruction and myocardial strain computation using data acquired from a real time pulse sequence that has been previously reported. The chirp Fourier transform is used for efficient computation, enabling a real-time continuous strain map at a rate of 25 frames/s. Coupled with a real time data path from the scanner to a laptop computer, this algorithm enables real time continuous monitoring of cardiac strain and is targeted for use in the early detection and quantification of ischemia during MR stress tests.