Nanotechnology holds great promise in addressing the challenges associated with cardiovascular diseases (CVDs), particularly coronary heart disease (CHD). Nanotechnology-assisted contrast agents and biosensors enhance the quality of computed tomography and magnetic resonance imaging, as well as improving the sensitivity of cardiac biomarker detection, aiding early diagnosis and risk stratification to guide future management. Nanoparticles are also being explored for the treatment of atherosclerotic plaques by increasing atherosclerotic fibrous cap thickness and reducing the central necrotic area. They can also deliver therapeutic biomolecules to coronary atherosclerotic plaques, reducing inflammation and removing cholesterol crystals and lipids. In the context of percutaneous coronary intervention (PCI) management, nanotechnology offers strategies to reduce the risk of stent thrombosis and restenosis, and has also shown potential to improve cardiomyocyte repair in patients affected by coronary artery disease. Moreover, nanotechnology has shown benefit in localizing cardiomyocyte damage and its maturation using angiogenesis, as well as in the treatment of valvular heart disease and infective endocarditis. However, nanoparticles have their own set of limitations, including potential toxicity, off-target effects and challenges in drug release control, as well as interpatient variability, which need careful consideration for successful clinical implementation. Overall, nanotechnology offers the potential to revolutionize CHD diagnosis and treatment, but addressing its limitations is vital for ensuring its clinical effectiveness and safety. Further research and development are required to evaluate the full potential of nanotechnology in the management of CVDs.