BACKGROUND:Coronary heart disease (CHD) is still the single largest health problem for Australia. It is considered essentially preventable. Risk of future events is highest in those who already have manifest disease (secondary prevention) and hence are likely to benefit from aggressive therapy. OBJECTIVE:This article explores issues of management of risk factors postacute myocardial infarction using a case vignette of a woman who consults her general practitioner after discharge from hospital. DISCUSSION:The consultation allows the GP to reassess the patient's CHD risk factor management including lifestyle factors, and reinforce the need for lifelong use of proven secondary prevention drug therapies and participation in a rehabilitation program. Reflective learning from this case should assist the treating GP and her or his colleagues to help other patients avoid a similar fate.