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Objective: To examine the present state of fatigue in young and middle-aged patients with coronary heart disease (CHD) and to identify the elements that may be affecting it. Methods: From December 2020 to June 2021, 240 young and middle-aged patients with CHD who were being treated in the cardiology department of a tertiary care hospital in Suzhou were chosen using a convenience sampling method in order to gather data on the patients' sociodemographic status, fatigue, social support, and stress. Results: Of the 240 disseminated questionnaires, 220 valid responses were returned, resulting in an effective recovery rate of 91.67%. The frequency of exhaustion was 51.8%, and the fatigue score was (5.27 ± 2.77). The stress score was (11.15 ± 3.36), while the overall social support score was (39.13 ± 4.72). Binary logistic regression analysis indicated that age, exercise, staying up late, stress, social support, high-sensitivity troponin T, high-density lipoprotein, and ejection fraction were independent risk factors for fatigue in young and middle-aged patients with CHD (P < 0.05). Conclusions: Fatigue is more prevalent in young and middle-aged patients with CHD. Clinical nurses can create a unique management plan for patients based on their lifestyle and behavioral patterns, stress levels, social support, and clinical signs to reduce fatigue. [ABSTRACT FROM AUTHOR]