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The present study was conducted to examine the effects of social support on adjustment to a first cardiac event. There were two goals: (a) to determine which function of support best facilitated adjustment and (b) to determine whether perceived or received support had a greater impact on psychological health. Sixty‐four patients and their spouses were interviewed shortly before hospital discharge and 3 months following discharge. The results indicated that perceived support has a greater impact on adjustment than received support and that received support does not necessarily indicate that needs are being met. The most helpful form of support was best understood by considering the stressor phase, patient and spouse needs, and the adjustment outcome. Consistent with previous research, however, the negative aspects of social relationships were more robust predictors of well‐being than the positive aspects of …