Background: We reviewed the current medical literature that pertained to the question of whether myocardial ischemia triggers the release of B-type natriuretic peptides (BNPs) and, in particular, whether transient exercise-induced ischemia can be detected by the measurement of changes in theses biomarkers. BNPs are well established as markers of left ventricular dysfunction, particularly heart failure. There is accumulating evidence that various conditions with the common denominator of myocardial ischemia are also associated with increased circulating levels of these peptides. Method and Results: Recently published methods and results, which include our published and unpublished data, were reviewed. Conclusion: The results show that exercise-induced ischemia or its associated regional wall-motion abnormalities trigger the release of BNPs and that the measurement of plasma levels of N-terminal pro brain natriuretic peptides and BNP before and immediately after symptom-limited exercise can distinguish patients with and without ischemia with a high degree of accuracy.