Approximately 800 patients who had cardiac surgery responded to a questionnaire surveying their psychological reactions to the entire surgical process. The overwhelming majority reported gratification with the results, and improvement in broad areas of functioning. Life pleasure and job performance were particularly bettered, while sexual adjustment was the least improved category. Despite the general improvement, anxiety was present at all stages, and psychological problems were especially manifest in the recovery room, with a third of the patients reporting symptoms of "Recovery Room delirium" or "early organic brain syndrome." Overall, patients described a generalized need for greater physician support, direction, and encouragement in the decision for surgery and in resuming activity following convalescence. Psychological problems interfered with optimal long-term benefit in a substantial group of patients. Overprotective families were also a common problem.