Objective: The disclosure of bad news is one of the most difficult tasks of a physician. This study explores how physicians prefer to disclose bad news to patients with acute coronary disease in emergency centres in Iran, and to their families.

Methods: A descriptive study was carried out during 2012–2013 on a sample of 280 patients and 180 families of patients admitted for suspected acute coronary syndrome in the emergency departments of two teaching hospitals in Tehran. Neither hospital had a stated policy on the disclosure of a diagnosis of acute coronary disease. The subjects' demographic characteristics and attitudes to the manner in which the diagnosis was revealed were registered in a questionnaire.

Results: The patients of acute coronary disease were more likely than their families to believe that the patient should be informed of the diagnosis and that the doctor-in-charge was the appropriate person to make the diagnosis known. Most participants thought that the patient should be informed immediately after the diagnosis. Nearly half the participants felt that the diagnosis should be disclosed at the patient's bedside.

Conclusion: Our findings indicated that the attitudes of Iranian patients of acute coronary disease towards truth-telling differed from those of their families. Therefore, physicians should be made aware of this fact and trained to develop the skills to disclose the diagnosis in an appropriate manner.