This paper presents the findings of a study designed to explore myocardial infarction (MI) survivors' experiences of their heart attack, to obtain their views on existing services and to gather ideas for a new, community-based cardiac rehabilitation initiative. Despite the increasing emphasis on the consumer ‘voice’ in health service delivery, little research has been published exploring the experience of MI from the patient's perspective. This is of particular significance given the study's location in a disadvantaged urban area where the uptake of conventional hospital-based cardiac rehabilitation is poor. The study is based on qualitative, semi-structured interviews with 20 myocardial infarction survivors in southeast Nottingham. Participants were identified from the list of those invited to participate in a local hospital's cardiac rehabilitation programme. The interviews were carried out in patient's home between one and 12 months after the MI, were tape recorded and subsequently transcribed. Thematic analysis reflected both the issues identified in the interview schedule but also some unexpected findings elucidating the survivors' own perspectives. The paper is structured around four key themes: the story of the heart attack; the way survivors' lives have changed; experiences of existing services and ideas for service development. The paper concludes that MI should be understood as a long-term rather than an acute condition and discusses the implications for service delivery.