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For the past 3 decades, researchers have explored vital exhaustion (VE) as a possible risk factor for coronary heart disease (CHD). In this chapter, we describe the unique factors that compose the construct of VE and present the latest findings regarding the implications of VE and CHD. DEFINITION OF VITAL EXHAUSTIONVE is characterized by excessive fatigue; a lack of energy; feeling dejected, defeated, or hopeless; increased irritability; loss of libido; and a sense of burnout; for example, some people report feeling "like a battery losing its power" (Appels & Mulder, 1989). VE has been described as a state of severe fatigue that people reach when their mechanisms for coping with chronic stress fail (van der Ven et al., 2003). Although patients who score high on measures of VE report feeling run down, or that they cannot get their energy back, they often deny common symptoms of depression, such as feeling sad or losing interest or pleasure in things they usually enjoy (van Diest & Appels, 1991).