Default table structure

I am making the assumption that when a table is created, it is always
a heap. Is this in fact true ?

If so, then the only way to get keyed access is through the use of an
index.

I use Ingres at work and it is great being able to change the
structure of a table so that another index isn't needed.

i.e.
create table x ( key varchar(8), value varchar(64));
modify x to btree on x;

Is something similiar possible in Postgresql, if not, are there any
plans to implement something similiar.

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