A myocardial infarction can result in disrupting the entire family system and requires reorganization and adaptation in order to ensure the proper functioning of marriage. Study is aiming to compare functioning of marital dyad before and after myocardial infarction from perspective of patient’s spouse. Furthermore, the study takes into account gender differences in the assessment of the dyad relationships. The respondents (60 spouses of patients - 17 men, 43 women) assessed the functioning of the marital dyad using the Family Assessment Questionnaire (modified by Cierpka). The first group of respondents was tested in the period immediately after a heart attack, and the spouses assessed the period of functioning before the onset of a heart attack. The second group was tested during the period of over one year after a heart attack. The results in both groups show a satisfactory level of marital relationships. Spouses in the second group assessed the overall marital functioning worse, as well as functioning in four dimensions, as compared with the assessment made by the respondents in the first group. Gender differences were also reported. Conclusion: From spouse’s perspective marital dyad functioning after myocardial infarction is worse than before that. One of the reasons for such situation could be near death experience of the spouse and necessity for reorganization of family life. Family context is very important for recovery after myocardial infarction and it seems to be sensible to include patient’s spouse to psychotherapeutic work. Furthermore, marital relations were more negatively assessed by women