Background: When a parent is living with heart disease, it impacts the entire family. To fully understand the effect, the perspectives of all family members need be analysed together as a unit.

Objective: To identify what characterises family life and relationships in families with adolescents, with a parent living with heart disease.

Design: Qualitative study with an inductive approach.

Setting: In three Scandinavian countries between 2019 and 2022.

Participants: A total of 28 families with 83 family members, from three university hospitals were included. Inclusion criteria were families with a parent living with any type of heart disease, within six months and up to five years since diagnosis and having one or more adolescents living at home.

Methods: Data was collected through semi-structured individual interviews. Reflexive thematic analysis was used to identify patterns within families. This was followed by an ideal-type analysis, which resulted in a typology defining aspects of family experiences and responses of living with heart disease.

Results: A typology was developed describing four different family responses to heart disease: resilient, fragile, overwhelmed, and resigned. A family with a resilient response exhibits a collective approach, fostering solidarity and adaptability as they manage heart disease. A family with a fragile response shares a sense of belonging among family members, but struggles with concurrent stressors, navigating challenges individually without external support. A family with an overwhelmed response experience breakdowns in communication and helplessness in managing heart disease alongside various demands. A family with a resigned response relies on individual strategies leading to challenges for them to interact and understand each other.

Conclusions: Families affected by heart disease handle their new life circumstances in various ways. Strong family cohesion and supporting networks emerged as crucial elements in helping families cope with the multifaceted challenges associated with living with heart disease.