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active occupations where more calories are needed, some vegetable fats could be taken in their refined form. Usually these are combined in the cooking process, as in making bread. Certain fats, however, are clearly better from the standpoint of cholesterol control. Measuring the ratio of polyunsaturated to saturated fat (P: S Ratio) will help to establish the relative risk or benefits of certain seed oils. Corn, safflower, and soy oils are the best from the standpoint of polyunsaturated fats. The monounsaturated fats found in olives and olive oil convey a protective benefit on the heart and arteries. Peanut and cottonseed oil are of lesser value. It is crucial to avoid entirely the consumption of shortening, lard, and butter, for these hardened fats will always tend to increase the cholesterol content of the blood. Recipe books are available, which enable the average cook to lower greatly total fat consumption as well as choose the most healthful sources. Signs and symptoms of heart disease challenge medical experts as well as laymen to find an accurate diagnosis. Chest pain is usually one of two principal qualities in heart disease. One type, called angina pectoris, is a transient pain, usually described as a pressure, aching, or squeezing in the area behind the left breast and associated with exercise. It may come on gradually as in walking up a hill or while mowing the lawn, or the pain may be triggered by stress, as in watching violent sports on television or by getting into an argument. Sometimes angina may arise after a heavy meal, because of the increased workload that digestion imposes on the heart. When exercise is a triggering factor, rest will within minutes relieve the pain. Sometimes an improvement of circulation results in the hands or feet by immersion in warm water to accelerate this relief process. In fact, it is important to keep the extremities warm when exercising on a cold day, to avoid chilling and thus reduce congestion around the heart. The heart attack, or acute myocardial infarction, presents suddenly with chest pain of a much different character. Although in the elderly this serious event may occur silently, for most younger individuals a sudden heart attack produces definite symptoms. Occasionally, however, it may resemble heartburn, a digestive problem, or may be thought to be related to indigestion. Classically the pain of a heart attack is located beneath the breastbone or left portion of the chest. Patients describe their chest pain as vise-like, squeezing, a tense, aching pain that at times radiates into the left shoulder or arm, or up into the neck or jaw. This pain persists, sometimes for hours, and may be associated with collapse or a catastrophic sudden death. About two out of seven individuals having an acute heart attack will die before reaching the emergency room.