If the contents and topics covered thus far in this book have proved anything, it is that there is still little definitive science to guide us in relation to optimally managing people living with heart disease from a climatic perspective. And yet, there is ample epidemiological evidence to suggest why we need to change the paradigm of clinical management on this basis. Thus, the title of this chapter might have been extended with a ‘thus far’. Moreover, it could well have been structured with a list of (Donald Rumsfeld-inspired) “known-unknowns” and even “unknown, unknowns”. Nevertheless, there is sufficient evidence to start an important conversation around what clinicians operating within a tertiary healthcare setting can do to promote resilience in people presenting with various forms of heart disease. This is the major focus of this chapter, whist providing some critical reflections on where the evidence falls short in protecting people from both current climatic conditions and that resulting from future climatic change.