The problem of maximizing the performance of the detection of ischemia episodes is a difficult pattern classification problem. The motivation for developing the supervising network self-organizing map (sNet-SOM) model is to exploit this fact for designing computationally effective solutions both for the particular ischemic detection problem and for other applications that share similar characteristics. Specifically, the sNet-SOM utilizes unsupervised learning for the "simple" regions and supervised for the "difficult" ones in a two stage learning process. The unsupervised learning approach extends and adapts the self-organizing map (SOM) algorithm of Kohonen. The basic SOM is modified with a dynamic expansion process controlled with an entropy based criterion that allows the adaptive formation of the proper SOM structure. This extension proceeds until the total number of training patterns that are mapped to neurons with high entropy reduces to a size manageable numerically with a capable supervised model. The second learning phase has the objective of constructing better decision boundaries at the ambiguous regions. At this phase, a special supervised network is trained for the computationally reduced task of performing the classification at the ambiguous regions only. The utilization of sNet-SOM with supervised learning based on the radial basis functions and support vector machines has resulted in an improved accuracy of ischemia detection especially in the last case. The highly disciplined design of the generalization performance of the support vector machine allows designing the proper model for the number of patterns transferred to the supervised expert.