Abstract Objective The aim of this study was to describe the coping strategies used by cardiac patients who are pursuing heart transplant and to determine which coping strategies are related to depression and self-reported disability. Method This is a cross-sectional design with 50 cardiac patients (74% male) who were inpatients being evaluated for heart transplant at a large medical center. Coping styles were measured using the COPE Inventory (Carver CS, Scheier MF, Weintraub, JK. Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol 1989;56:267–83). Depression was assessed with the Structured Interview Guide for the Hamilton Depression Rating Scale (HAM-SIGH-D; Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:56–62), and disability was assessed using the Sickness Impact Profile (SIP; Bergner M, Bobbitt R, Carter W, Gilson B. The Sickness Impact Profile: development and final revision of a health status measure. Med Care 1981;19:787–805). Results Patients reported using a variety of adaptive coping strategies, but depression and disability were only significantly correlated with maladaptive coping strategies. Multiple regressions demonstrated that denial had the strongest association with depression, and focusing on and venting emotions had the strongest association with disability. Conclusions Maladaptive coping styles, such as denial and focusing and venting of emotions, can serve as markers of emotional distress and disability that may identify patients who may benefit from psychologic and psychiatric interventions.