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February 12, 2010 -- 4:30pm EST Clinton and Eisenhower: Presidents, Hearts,
Stents and 55 Years Whatever your take on comparative effectiveness research, whether too many stents are used, etc., you have to admit it's pretty amazing. The advances made in diagnosis, bypass surgery and interventional catheter-based techniques have revolutionized the treatment of coronary artery disease. Especially when you look back at how this illness used to be treated (or not). The take-away from Bill Clinton's episode is that even though his quadruple bypass surgery was successful, the natural history of coronary artery disease is that it will progress. Surgery, angioplasty, stents, medicine -- none of these are cures, but they are interventions in this progression. Along with the medications, exercise, diet and smoking cessation, the natural history can be slowed down. Clinton, having experienced this pain previously, knew it was significant and did precisely the right thing: he saw his cardiologist. |
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It's
a holiday concurrence: Valentine's Day and President's Day and American
Heart Month -- and former President
Bill Clinton who got his heart
fixed six years ago and
just 
Dr.
William W. O'Neill, Professor & Executive Dean for Clinical Affairs,
University of Miami, Division
of Cardiology has a favorite lecture that he gives on this topic. He goes back
to 1955 and describes how then President Eisenhower's chest
pains were first diagnosed as gastric upset and finally almost
a day later an EKG showed
he was in the midst of a massive heart attack. But there was nothing
any doctor could do then, except give Ike morphine for the pain.
The heart attack had to play itself out, Ike's heart muscle was damaged
and he was in the hospital for 7 weeks. He didn't return to work
for 3 months. (for you young folk, our Vice President
at the time was Richard Nixon!). Ike did continue as President and,
in fact, was re-elected to a second term (after all, he was THE
hero of WWII). But without question, his ability to
lead a fully active life was significantly compromised and ultimately,
in 1967, he succumbed to heart disease. (A print version of Dr.
O'Neill's lecture can be found