Background: Prevalence of myocardial infarction (MI) is increasing in younger patients. These patients have distinct needs post MI and are also the poorest attenders at cardiac rehabilitation (CR). Little is known about how younger patients come to terms with their diagnosis, evaluate their personal risk and motivate themselves for lifestyle change. Aim: The aim of the study is to explore the issues encountered by younger patients, who have families, as they attempt lifestyle changes post MI. Methods: A Heideggerian phenomenological methodology employing semi-structured interviews was used with participants (n=7), 6–8 weeks following discharge from hospital. All participants were diagnosed with an MI for the first time, were <50 years of age and had dependent children. Framework analysis was used to identify themes within the interviews. Results: Five major themes were identified: guilt, grief, disbelief, motivation for change, and family support and involvement in lifestyle change. Post MI, family responsibilities were a strong motivator for survival and lifestyle change. The participants were keen to live healthier lives, improve their risk profile and encourage others to do the same. Conclusion: This study confirms the importance of considering the patient’s age and family responsibilities within the setting of preventative cardiology. A more patient-centred and tailored approach to CR is needed with younger patients to improve uptake owing to their lifestyle and family commitments. There is need for further research in the acceptability of the current provision of CR.