Depression in cardiac patients leads to increased mortality and morbidity. Several practice guidelines recommend screening for depression as part of standard cardiac care. However, a recent systematic review concludes that as a result of the limited efficacy of depression treatment in terms of depression outcomes, screening for depression in cardiac patients does not lead to a reduction in morbidity and mortality. Before implementing standard screening for depression in cardiac care, effective interventions for depressed cardiac patients have to be developed . We make two suggestions: a) optimizing depression treatment, and b) additional counseling for risk behavior. The next step would be to evaluate the effects of depression screening in cardiac patients. Only when an effective intervention has been developed and depression screening is found to be effective in terms of depression and cardiovascular outcomes, should implementing standard screening for depression in cardiac care settings be considered.