A panel of medical experts has expanded the list of people who should not receive the smallpox vaccine to include, at least for now, heart patients and those at risk for heart disease. The decision by the Advisory Committee on Immunization came days after two health care workers with pre-existing heart conditions suffered fatal heart attacks after being vaccinated. News of the deaths and that of a third person, a National Guardsman who died within days after receiving the smallpox vaccine, prompted the recommendation. The Centers for Disease Control and Prevention has received several reports of other heart ailments, including two cases of angina, and two of myocarditis or pericarditis, a condition that has also been reported among several military troops that have been vaccinated against smallpox. At the special meeting, the advisory committee decided that people with known heart disease or with three or more risk factors--such as diabetes, high cholesterol, and high blood pressure--should be excluded from the voluntary smallpox vaccination program.