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 before 1985 and, as a result, teaching opportunities directed at lifestyle change have been curtailed. The two case studies reported here of men with CHD reveal the importance of the patient’s early life experiences when developing meaningful recommendations for changing their lifestyle.