This review examines the current state of the art lab-on-a-chip and microfluidic based biosensor technologies used in the detection of cardiac biomarkers. The determination and quantification of blood based, cardiac biomarkers are crucial in the triage and management of a range of cardiac related conditions, where time delay has a major impact on short and longer-term outcomes of a patient. The design and manufacturing of biomarker detection systems are multi-disciplinary in nature and require researchers to have knowledge of both life sciences and engineering for the full potential of this field to be realised. This review will therefore provide a comprehensive overview of chip based immunosensing technology as applied to cardiac biomarker detection, while discussing the potential suitability and limitations of each configuration for incorporation within a clinical diagnostics device suitable for point-of-care applications. © 2011 The Royal Society of Chemistry.