Background: Risk factor reduction has been linked to personal perceptions of risk, yet few data exist about women's personal perceptions of coronary heart disease (CHD) risk, especially women who have experienced a cardiac event or intervention.

Objective: The purpose of this study was to explore perceptions of risk for CHD and to examine perceptions of risk-reducing behaviors in women with known CHD.

Methods: Because women's attitudes are conceptualized to be embedded in their everyday practices, an interpretative qualitative approach was chosen to reveal this phenomenon. The purposive sample consisted of 7 women with CHD. Interviews were conducted and transcribed verbatim. Data collection continued until saturation occurred. Efforts were made to increase trustworthiness through participant review of transcripts, peer debriefing, and using field notes.

Results: Three major themes emerged from the data: "out of sight, out of mind," "why doesn't he talk to me like that?" and "it's scary." The women indicated their CHD was currently not a major problem because they were asymptomatic or did not "feel sick," which led to decreased focus on their CHD, including risk factor reduction. They expressed the desire to return to normal, rather than focus on the chronicity of CHD. Participants felt that physicians treated them differently because they were women and that their concerns were taken less seriously. They perceived that the patient-physician relationship lacked open dialogue. Fear was experienced by all women, and many feared the unknown, especially not knowing when something was wrong with their heart.

Conclusions: Data indicated that, during stable periods in the CHD trajectory, women may not understand the chronicity of their disease and may not recognize the importance of reducing their risk for future cardiac events. Helping women understand CHD chronicity even when they may not feel sick may assist them in engaging in risk-reducing behaviors.