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Psychosocial and standard risk factors were assessed in 21 young males aged 32--45 admitted for acute myocardial infarction. All patients underwent extensive clinical, dietary and psychosocial investigation by a team of cardiologists, psychiatrists, dieticians, social workers and physiotherapists both during hospitalization and later at home. Most standard risk factors were found infrequently and the estimated risk of coronary disease would have been low. Heavy smokers (1--4 packs of cigarettes per day) totalled 20/21 patients. In every case the patients, before myocardial infarction, had sustained severe long-term stress in their professional, social and/or familial environments. With rigid and obsessive personality patterns, they appeared to be the prisoners of their problem situations and totally unable to relax. Severe psychosocial stress and heavy smoking appear to be almost constant findings in young males admitted with acute myocardial infarction.