[The psyche and cardiac infarct]

The psychosocial aspects of coronary heart disease before the first myocardial infarction (coronary-prone behaviour in interaction with chronic social risk situations and subacute life events) and the psychic reactions of patients after heart attack (anxiety, depression, denial and overmotivation as a coping strategy) are discussed. Answers are proposed for the following practical questions: Are psychosocial stressors as predictors of coronary disease scientifically documented and accepted as are the traditional risk factors? Must the psychosocial aspects of coronary disease be integrated in new ways into the management of myocardial infarction (comprehensive coronary care) in order to improve prognosis and quality of life for the patient and his family?