*Ammi visnaga, which dates back to Ancient Egyptian medicine, has a powerful antispasmodic effect on the coronary arteries and has proved useful against attacks of angina. Toxicity is extremely low and there are practically no side-effects, even with long-term use (Weiss RF. Herbal Medicine. Gothenburg: Ab Arcanum, 1988: 221). Available as Carduben (Madaus Laboratories, Cologne, Germany), it should be taken as stated on the package insert. Rapid symptomatic relief can be achieved in cases of acute angina, and it can be given safely in conjunction with strophanthin, digitalis, anticoagulants and hypotensives.

* Danshen (Salvia miltiorrhiza), a traditional Chinese herb, showed mild antithrombotic effects in rats (and so may not apply to humans), and is known to inhibit platelet aggregation and other clot-reducing activity (Yao Xue Xue Bao, 1993; 28: 241-5). Suggested dosage: 20 mg/kg body weight.

* Ginkgo biloba has anticoagulant properties, whether or not combined with anticoagulant drugs (Am Surg, 2001; 67: 33-5; Biochem Mol Biol Int, 1995; 35: 125-34). Suggested dosage: 120-240 mg/day (divided into two or three doses).

* Goldenseal, Oregon grape root, and barberry (Berberis vulgaris) root bark, all containing berberine, can treat and prevent irregular heart rhythms caused by ischaemia. In one study, 100 heart patients took berberine from one or more of these herbs. Monitoring showed that 62 per cent of them had 50 per cent or greater, and 38 per cent had 90 per cent or greater, improvement in their symptoms (Chung Hua Hsin Hsueh Kuan Ping Tsa Chih, 1990; 18: 155-6, 190). Suggested dosage (to be modified when necessary) for Berberis vulgaris tincture: 15 mL in water three times daily after food.

* Hawthorn, as used in the Crataegus-based homoeopathic preparation Cralonin, was found to be as effective as ACE inhibitor/diuretic drug treatments for most mild cardiac problems (Eur J Heart Fail, 2003; 5: 319-26). Extremely well tolerated, it is used for angina, heart rhythm disorders and minor forms of congestive heart failure. Controlled studies of Crataegus have revealed the following effects: increased coronary and peripheral blood flow, decreased arterial blood pressure and heart rate, and improved contractility of the heart muscle (Planta Med, 1981; 43: 105-20, 209-39, 313-22). Suggested dosage (all three times daily): dried berries, 0.3-1 g or in an infusion; liquid extract 1:1 in 25 per cent alcohol: 1-2 mL; tincture 1:5 in 45 per cent alcohol: 1-2 mL.

* Chamomile, motherwort, horse chestnut, fenugreek and red clover herbal supplements, contain coumarin, from which the blood-thinner warfarin and other anticoagulants are derived (J Clin Pharm Ther, 2002; 27: 391-401). Suggested dosages: chamomile, 400-1600 mg/day (divided); horse chestnut, 300 mg/day; fenugreek, 50 g twice daily (powdered seeds); red clover, 80 mg/day.

* Bilberry, dong quai, feverfew, ginseng, turmeric, meadowsweet and willow herbal supplements have antiplatelet activity (J Clin Pharm Ther, 2002; 27: 391-401). Suggested dosages: bilberry, 80-240 mg/day (divided); dong quai, 200 mg two or three times daily; feverfew, 100-250 mg once to three times daily; ginseng, 1-2 g/day (root), 100-300 mg/day (extract); turmeric, 100-500 mg three times daily with food; meadowsweet, 2 tsp dried herb in 5 oz water, soaked for 10 min; willow, 60-240 mg/day.