Before 1985, the goal of care for patients with coronary heart disease (CHD) was to support them through their infarction. Today, the treatment goal is to minimize ischemia and eliminate avoidable risk factors. High-tech interventions and long-acting pharmacotherapies have become the gold standard of treatment. Lengths of hospital stay are 50% less than what they were before 1985 and, as a result, teaching opportunities directed at lifestyle change have been curtailed. Unless patients are consistently referred to cardiac rehabilitation or are followed closely after discharge, they have little support as they attempt to incorporate and maintain new, healthier behaviors. The two case studies reported here of men with CHD reveals the importance of the patient's early life experiences when developing meaningful recommendations for changing their lifestyle. The small sample limits the generalizability of the findings.