Objective: This study aimed to investigate the interrelationship between trauma exposure characteristics of myocardial infarction (MI), MI patients' personality traits, coping strategies, post-MI PTSD, and general psychological distress. Method: One hundred and twenty MI patients were recruited from two general practices. The MI patients were interviewed using a MI experience questionnaire and completed the Posttraumatic Stress Diagnostic Scale (PDS), the General Health Questionnaire-28 (GHQ-28), the NEO-Five Factor Inventory (NEO-FFI), and the COPE Scale. Results: Neuroticism was directly associated with post-MI PTSD and general psychological distress, while agreeableness did not link to the outcomes directly. Neuroticism influenced MI exposure characteristics which in turn influenced PTSD. Agreeableness affected PTSD and general psychological distress through MI exposure characteristics. Neuroticism influenced problem-focused coping which in turn affected general psychological distress. Agreeableness influenced problem-focused coping which in turn affected PTSD and general psychological distress. Conclusions: Patients developed PTSD and general psychological distress following MI. Neurotic and antagonistic personality traits combined with patients' subjective experiences of MI and usage of problem-focused coping influenced the severity of outcomes. © 2011, Baywood Publishing Co., Inc.