The objective of this study was to investigate the prospective impact of vital exhaustion on recurrence after acute myocardial infarction (AMI) in women. Women ≤ 65 years, mean age = 55.30, SD = 7. 63, N = 110, consecutively admitted to a coronary care unit with AMI were examined after three-six months, and followed for five years. Vital exhaustion was assessed using an early version of the Maastricht Questionnaire. A recurrent event was defined as cardiac death, AMI or a revascularization procedure. Forty-five recurrent events were found (in 41% of the study group). One standard deviation (8.4 points) increase of vital exhaustion scores was associated with a 53 % increased risk of a new event and a score above the median was associated with a hazard ratio of 2.24 (95% CI 1.21-4.14). These results remained after adjusting severity of chest pain and significant coronary stenosis. In conclusion, it was found that vital exhaustion is a marker of poor prognosis in women with AMI. The relationship appears to be independent of signs of underlying disease, including severity of chest pain and significant coronary stenosis.