This descriptive exploratory study conducted between 2000 and 2007 aimed to explore patients' search for causal meaning of myocardial infarction across the first 5 years of recovery. Qualitative data were collected by audio-taped interviews with 70 patients. This paper discusses patients' interpretations of the cause of their illness guided by Frankl's theory of Logotherapy and Existential Analysis. Research demonstrates that the sudden onset of a life-threatening illness appears to trigger a search for causal meaning, in an attempt to find an answer to the question, 'Why me?' The three themes found across time were determining the cause, finding fate- or faith-related causal meaning for their illness, and understanding the personal significance of illness. These findings corroborate with Frankl's Theory, whereby individuals' beliefs can give meaning to their illness and life. Causal meaning may enable persons to change their attitude to life, including their unavoidable suffering. Recommendations were set in order to increase awareness among nurses and health professionals and bridge the gaps in the current clinical practice in hospitals and community.