On the basis of current epidemiological and clinical research, this article describes how mental health symptoms are associated with heart disease, a major chronic condition that occurs primarily in middle and late life. The article describes the culturally and historically important link between heart and mind. It then describes depression and anxiety, both as manifestations of heart disease and as contributors to the disease prognosis. In addition to discussing risk factors, the article discusses factors that protect against the co-occurrence of mental health problems and heart disease such as positive attitudes, coping mechanisms, social supports, and spirituality. Further, the article highlights issues concerning the clinical assessment of mental health symptoms and interventions to address them. Finally, it summarizes the collaborative chronic care model, in which health care professionals--including medical, mental health, gerontological, and community social workers--assess and manage patients with comorbid mental health symptoms and heart disease.