Left ventricular (LV) dysfunction, ventricular arrhythmias, and ischemic jeopardy independently determine outcome after recovery from acute myocardial infarction. Because death and reinfarction are most common early after hospital discharge, predischarge assessment of risk is optimal. Noninvasive methods can adequately detect LV dysfunction and ventricular arrhythmias, but coronary angiography is needed to assess ischemic risk in several subsets of patients. Management should be guided by the magnitude and functional nature of risk factors.