Although the correlation between alcohol intake and heart disease has been known for a century, the information tends to be dominated by historical and anecdotal reports. The more recent literature shows that alcoholic damage leads to metabolic and structural changes in all tissues of the heart, with the result that the contractile element, coronary vessel or specific conduction tissue may fail. The resultant symptoms are heart failure, angina pectoris and arrhythmias. These correlations are discussed.