Facts: 1.5 million people suffer from angina in the UK.

Symptoms: During an angina attack, there are chest pains which may spread to the shoulders and both arms. Attacks are often triggered by activity and stop within minutes of the person resting. In severe cases, even everyday activities like climbing the stairs can start an attack.

Causes: Atherosclerosis is where arteries are partly blocked by fatty deposits that build up and harden on their inside wall. If this happens in a coronary artery it can cause angina or even a heart attack.

The fatty deposits increase over a period of years. They are made worse by high levels of animal fats and cholesterol in the diet, although some people are genetically more susceptible to developing atherosclerosis than others. Eating less fat, particularly saturated fat, and eating a high fibre diet can lower the total amount of cholesterol in the blood and particularly the LDL cholesterol (this is the harmful form of cholesterol). Medicines such as statins are also used to reduce cholesterol levels.

During activity the heart rate increases and muscle cells demand more oxygen. The narrowed arteries cannot supply enough blood to keep up with this demand and this triggers the pain of an angina attack which forces the person to rest.

Diagnosis: Patients will describe the history of their angina attacks. A cardiac angiogram uses a dye in the blood to allow the flow through the cardiac arteries to be observed by x-ray. An exercise tolerance test will observe the response to increased activity.

Treatments: Angina sufferers may be able to avoid the activities that trigger an attack. Nitrates such as glyceryl trinitrate, in the form of a tablet placed under the tongue during an attack help to reduce the strain on the heart and speed up recovery. Other medicines such as beta-blockers or calcium channel blockers can be used to reduce the frequency of angina attacks.

If the atherosclerosis is severe, a person may need a heart bypass operation or coronary angioplasty (see below).

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Facts: Congestive heart failure is the most common cause of death in people over 65.

Symptoms: The heart weakens gradually over a period of years. A person suffering from long term heart failure will generally be tired, breathless and find any form of physical activity a problem.

The heart cannot pump effectively and this causes a build up of blood pressure in the lungs. This forces fluid in to the air sacs and the lungs cannot work efficiently. The person may have persistent cough to try and clear the fluid.

Swollen ankles are a sign of fluid building up in the body tissues (called oedema). The kidneys need a good blood pressure to remove excess water from the body and in heart failure they cannot work to their full efficiency.

Causes: Heart failure can be caused by the damage that happens during a heart attack. Long term problems such as high blood pressure, heart valve damage, emphysema of the lungs and irregular heart rhythmn can add extra strain to the heart which eventually causes failure.

Diagnosis: Patients may be able to describe the symptoms of heart failure. Using a stethoscope, a doctor can listen for rasping sounds of fluid in the lungs. Measuring blood pressure and looking for signs of oedema are also ways to diagnose heart failure.

Further tests may include a type of ultrasound scan of the heart, called an echocardiogram.

Treatments: Medicines called diuretics can be given to help the kidneys remove the excess water. This will help reduce the fluid in the lungs and also swollen ankles. ACE inhibitors will help to dilate, or widen, the arteries to increase the blood flow and so reduce some of the strain on the heart.

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Facts: More than 28,000 people have a heart bypass operation in the UK each year.

Symptoms: Patients suffering from a narrowing of a coronary artery (see atherosclerosis) may need to have an operation to divert blood around this blockage.

Diagnosis: A dye injected into the blood allows the flow through coronary arteries to be viewed by x-ray. This will show areas of the heart muscle that are not receiving a good supply of blood from the coronary arteries.

Treatments: A section of vein from the leg or a portion of the mammary artery in the chest is removed and grafted onto the aorta to create a diversion or "bypass" to allow the blood to flow freely around the blockage in the coronary artery. This restores a full blood supply to the affected part of the heart muscle.

A "triple heart bypass" would have three separate grafts made at the same time. Three or four grafts per operation are quite common.

Coronary angioplasty is an alternative treatment for some people. In coronary angioplasty a small inflated balloon is used to squash the fatty deposits in the narrowed artery, allowing the blood to flow more easily.

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• Is smoking worth the risk of heart disease?

Alcohol
In adults, having one or two drinks a day is linked with a reduced risk of heart disease. However, in the UK it is estimated that 38% of men and 21% of women drink more than is healthy for their hearts. Excessive drinking also leads to obesity.

• Some teenagers are drinking the equivalent of 20 pints over a weekend. What effect might this 'binge drinking' have on them now and in the future?

Diet
Lots of saturated animal fats in the diet can cause atherosclerosis and heart disease. Healthy diets avoid fried foods, fatty meat, full-cream milk and salt. Using vegetable oil and eating more fresh fruit and vegetables will help to keep the heart healthy.

• Is your diet high in animal fats?
• What could you change to make it more healthy?

Exercise
Regular exercise is good for the heart. It gives it a workout and keeps the heart muscle efficient. Walking for 30 minutes at least five times a week is recommended.

• Do you do enough exercise each week?

Overweight
Being over weight puts an extra strain on the heart and also contributes to high blood pressure and diabetes. In the UK, 17% of 15 year-olds are clinically overweight.

• What causes young people to become overweight?

Inheritance
Heart problems seem to "run in the family". Some people have inherited genes from their parents which make them more likely to get heart disease. This is linked to many of the heart attacks in men aged between 40 and 55.

Would you want a genetic test to see if you were at high risk of a heart attack, or would you prefer not to be aware of it?

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