Ischaemic heart disease was unknown in Papua New Guinea until 1964 when the first case was reported. Since then there has been a rapid rise in frequency confined to its major urban area, the capital, Port Moresby. The findings are based on post-mortems in Port Moresby and in Goroka, one of the major towns in the Highlands with its more traditional population, where ischaemic heart disease is now beginning to be seen.