Mr. Cheney's Chest Pain - And Heart Attack

We wrote this article early in the morning, just after Mr. Cheney had been admitted to the hospital. It is now clear that Mr. Cheney's chest pain was not due to angina but to a heart attack. He had an angioplasty and the insertion of a stent.

We hope this article may still be of some use and give you a Doctor's View of the situation at the time. Chest (and shoulder) pain should not be taken lightly!

-- Medical Editor, MedicineNet.com

November 22, 2000 (9AM) -- The Republican vice presidential candidate, Mr. Dick Cheney, was admitted to George Washington Hospital today with pain in the chest and also in his shoulder.

Mr. Cheney's initial EKG (electrocardiogram) and his initial blood tests for cardiac enzymes were reportedly normal.

Mr. Cheney has a past history of heart problems. Before age 50, he experienced three heart attacks and had a quadruple cardiac bypass. Cheney's first attack at age 37 was in 1978. He had a second heart attack in 1984 and a third one in 1988. In August of 1988, Cheney had the bypass surgery.

Mr. Cheney reportedly has stopped smoking, exercises regularly and takes medicine to lower his cholesterol.


MEDICAL COMMENTS

Did Mr. Cheney really need to go into the hospital?

We would say "absolutely, yes." We agree fully with Mr. Cheney's being hospitalized. It makes very good sense that he be carefully checked to make sure that he has not had a heart attack.

Why would we be worried about a myocardial infarction (a heart attack)?

Well, there are several reasons. First, the chest pain. Mr. Cheney has reportedly had chest pain. This can, of course, be due to a heart attack.

Second, there is the shoulder pain. Mr. Cheney reportedly also had shoulder pain. Pain from the heart is also commonly "referred" to other areas of the body such as the shoulder and arm. This is typical.

Third, there is his past heart history. Mr. Cheney has had three heart attacks. Although they have been called "mild," no matter what severity they were, they constitute a very important history of heart disease.

And fourth, the importance of his heart disease was confirmed by his needing bypass surgery. You do not have a coronary bypass for insignificant heart problems and you surely do not have a quadruple bypass for an isolated problem in just one coronary artery. Mr. Cheney clearly had widespread coronary artery problems at the time.

In sum, the presence of pains in Mr. Cheney's chest and shoulder, particularly given his cardiac history, mean that without question he merited hospitalization to rule out a heart attack.

If Mr. Cheney did not have a heart attack this time, what might the problem be?

If all of Mr. Cheney's tests including his ECG (electrocardiogram) and his cardiac enzymes levels stay normal, Mr. Cheney's doctors may, we think, conclude that he has not had a heart attack.

If Mr. Cheney has not had another heart attack, what was it?

Well, we would then think it likely that Mr. Cheney may have had an attack of angina pectoris.

Angina pectoris is chest pain that is typically severe and crushing with a feeling just behind the breastbone (the sternum) of pressure and suffocation. It is due to an inadequate supply of oxygen to the heart muscle.

(Incidentally, the term "angina pectoris" comes from the Latin "angere" meaning "to choke or throttle" + "pectus" meaning "chest". Angina pectoris was first described by the English physician William Heberden (1710-1801) and is most commonly called "angina.")

What will they do if Mr. Cheney has, in fact, had another heart attack?

There are a number of choices available to Mr. Cheney and his physicians. Aside from another bypass, there is balloon angioplasty (to open up a narrowed area within a coronary artery) and there is a stent.

What is a stent?

A stent is a tiny tube. Stents are often inserted in diseased coronary arteries to help keep them open after balloon angioplasty. The stent then allows normal flow of blood and oxygen to the heart muscle.

How can I learn more about these kinds of heart problems?

For more information about these matters of the heart, please see the following articles of MedicineNet.com:

And to be up to date about cholesterol?

-- Medical Editor, MedicineNet.com
Last Editorial Review: 2/1/2005




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