Background: Rational policy making could benefit from an estimate of the deaths that might be prevented or postponed (DPP) by developing more effective behavior change programs and fully implementing technologies that are currently available to prevent and treat heart disease. Methods: To estimate the impact of developing more effective behavior change programs and fully implementing currently available technologies to prevent and treat heart disease, we created a hypothetical population ages 30-85 years resembling that of the United States. We divided the population into three prevalence pools (no apparent heart disease, known heart disease without left ventricular systolic dysfunction [LVSD] and known heart disease with LVSD). We divided clinical events into one of three types: out-of-hospital cardiac arrest, acute or emergent heart disease events, and non-emergent heart disease events. We defined the difference in total DPP between current implementation levels and full implementation levels as the outcome of interest. Results: In this hypothetical population, 87,500 would have no apparent heart disease; 9900 would have heart disease without LVSD; and, 2600 would have heart disease with LVSD. Expected death rates for the three subpopulations would be 0.007, 0.035, and 0.067, respectively. During 1 year without treatment 1133 individuals would be expected to die: 613 without apparent heart disease, 346 with heart disease but no LVSD, and 174 individuals with heart disease and LVSD. The DPP that would result from implementing lifestyle changes and prescribing medications in the prevalence pools would be 648 and the DPP from implantable defibrillators might be another 60. The DPP from fully implementing treatments during the three types of acute cardiac events would be 70. Conclusions: If effective behavior change programs were developed and currently available heart disease prevention and treatment technologies were fully implemented, approximately 62% of all deaths among adults in the United States might be prevented or postponed. Fully implementing currently available interventions during acute cardiac events would prevent or postpone about 7% of all deaths.