A multimethod psychological assessment of a 46-year-old man hospitalized with acute myocardial infarction revealed signs of interpersonal conflict and strong repression of affective experiences on projective methods despite no clinical indicators of psychological distress on self-report scales.
Self-report instruments did not reveal clinical indicators of psychological distress in the patient following acute myocardial infarction.
Projective methods revealed signs of conflict in interpersonal relationships and strong repression of affective experiences not detected by self-report measures.
A multimethod design combining self-report instruments and projective methods enriched understanding of the patient's psychological functioning.
The case study suggests a potential psychodynamic link between emotional repression and acute coronary syndrome.
This research describes a psychological case study of a 46-year-old man who was hospitalized after a heart attack. After his condition was medically stabilized, he agreed to undergo psychological testing using two types of tools: standard questionnaires where he rated his own feelings (self-report scales) and projective tests, which are less direct assessments where responses are thought to reveal unconscious psychological patterns. The striking finding was that the two types of tests told very different stories — the questionnaires showed no signs of emotional distress, while the projective tests revealed significant repression of emotions and difficulties in interpersonal relationships. This research suggests that people who have heart attacks may have underlying psychological difficulties — particularly a tendency to suppress or repress emotions — that they themselves may not be aware of or may not report when asked directly. The gap between what the patient reported about himself and what the projective tests revealed points to the value of using multiple assessment methods when evaluating the psychological wellbeing of cardiac patients. The study also suggests that identifying these hidden emotional patterns could be useful in helping patients find ways to cope with heart illness. Because this is a single case study of one individual, the findings cannot be broadly generalized to all people with heart attacks. However, it illustrates how psychological assessment in a cardiac care setting might uncover emotional and relational dynamics that standard self-report tools alone would miss, and how a psychodynamic perspective might contribute to a more complete picture of a patient's health and recovery resources.
Antonechen A, Belot R, Pasian S. (2026). Psychic Dynamics in an Adult With Acute Coronary Syndrome: A Case Study.. Psychoanalytic review. https://doi.org/10.1521/prev.2026.113.2.103