Mortality from cardiovascular disease (CVD) accounts for over 30% of all deaths globally, necessitating reliable diagnostic tools. Prompt identification and precise diagnosis are critical for effective personalized treatment. Nanotechnology offers promising applications in diagnostics, biosensing and drug delivery for prevalent cardiovascular diseases. Its integration into cardiovascular care enhances diagnostic accuracy, enabling early intervention and tailored treatment plans. By leveraging nanoscale innovations, healthcare professionals can address the complexities of CVD progression and customize interventions based on individual patient needs. Ongoing advancements in nanotechnology continue to shape the landscape of cardiovascular medicine, offering potential for improved patient outcomes and reduced mortality rates from these pervasive diseases. Article highlights Nanotechnology in early cardiac marker detection Nanoparticles possess a wide range of capabilities for diagnostic purposes, namely in the realm of early identification of atherosclerosis by the quantification of inflammatory markers. Precision and effectiveness are essential for the detection of heart-type fatty acid-binding protein (H-FABP) as an early biomarker for cardiac events. Several techniques, such as chromatography (HPLC, GC-MS) and immunoassays (ELISA, LFIA), can be used with distinct advantages in terms of sensitivity, specificity and turnaround time. Challenges with immunoassays include the occurrence of cross-reactivity and interference, while chromatographic procedures require specialized equipment and skilled personnel. MicroRNAs (miRNAs) control gene expression and exhibit stability in human fluids, rendering them valuable as biomarkers. miRNA-21 is a biomarker that is specifically intriguing for heart failure due to its involvement in both the etiology and diagnostics of the condition. Therapeutic approaches aimed at miRNA-21 entail the use of antagomiRs and miRNA mimics, which present opportunities for precision medicine. miRNA-21 is involved in heart hypertrophy, fibrosis and remodeling, and its abnormal regulation offers diagnostic and prognostic information. Current challenges & limitations in early detection Early diagnosis of heart issues is essential for effective treatment and better outcomes. Advanced cardiac implantable electronic devices (CIEDs) are increasingly employed for congestive heart failure, ventricular tachyarrhythmia and bradyarrhythmia. Regular battery changes remain necessary, despite breakthroughs in battery design and CIED programming, resulting in cost, risk and inconvenience. Transvenous lead extraction for damaged leads is potentially fatal. Spin-echo (SE) sequences, enhanced by ECG-gating, improve myocardial-blood contrast but have limited temporal resolution and motion-related artefacts. Ejection fraction (EF), a typical systolic function measure, is susceptible to inaccuracies due to subjective endocardial boundary tracing. Emerging biochemical diagnostics for heart disease encounter hurdles in standardization, preanalytical variability and imprecision. Reliable economic evaluations of test costs and benefits are lacking. Immunoassays for novel cardiac proteins use antibodies targeting various epitopes, resulting in varying results and interpretation challenges. "Sandwich" immunoassays may produce false positives due to disturbances in antigen-antibody reactions and interference by factors like rheumatoid factor or human antimouse antibodies. The presence of endogenous substances like hemoglobin and bilirubin can lower the sensitivity and specificity of troponin assays. POC devices for cardiac troponins and BNP detection are sensitive yet expensive and time-consuming. Recent advances & innovations in early detection Patenting theranostic nanoparticles, developing a UV-cross-linkable cardiac patch with gold nano-rods and creating nanoparticle-based stem cell conjugates for post-infarction treatment are significant advances in spatially designed nanoparticle trials in CVDs, neurological disorders and cancer therapies. AuNPs and iron oxide nanoparticles improve imaging of atherosclerotic plaques and CVDs, with CNA35-AuNPs found to improve contrast and detection in CT images. MRI, utilizing T2 and T1 mapping, 4D flow imaging and nanoplatforms, enhances imaging accuracy and precision, replacing biopsies for heart structure, function and tissue characteristics. PET imaging in CVDs uses radioactive tracers for 3D imaging of biological processes, such as myocardial perfusion using 13N-ammonia, enhanced by nanoplatforms and targeting ligands improving specificity and effectiveness. Enhanced ultrasound imaging with nanoparticles targeting vascular markers enhances echogenicity and contrast-to-noise ratio, resulting in safe and effective real-time imaging. MSOT and PAI use photoacoustic imaging for high-resolution carotid artery and atherosclerosis detection, with nanoparticles improving sensitivity, contrast and specificity. MPI, a real-time, high-resolution imaging method, enhances signal strength and accuracy with optimized nanoparticles for tracer detection, multiplexed imaging and sensitivity. [ABSTRACT FROM AUTHOR]