TIME EUROPE
December 4, 2000, Vol. 156 No. 23
Just how bad was it?
By CHRISTINE GORMAN
Dick Cheney's heart condition has been the subject of speculation and
controversy from the moment George W. Bush picked him as his running
mate. Cheney had suffered three heart attacks in 10 years, his first at age
37, and in 1988 underwent quadruple-bypass surgery to relieve blockages
in his coronary arteries. From a medical perspective, the news last week
that he had suffered a fourth heart attack wasn't all that surprising.
Indeed, Cheney is so attuned to the vagaries of his heart that when he was
awakened last Wednesday around 3:30 a.m. by a discomfort in his chest, he
realized at once that he couldn't dismiss it as simple indigestion. It wasn't
intense pain, Cheney told the press two days later. But, he said, "it lasted
long enough, it was steady enough, it didn't change when I breathed deeply
or moved around" that he decided — correctly — to have it checked without
delay.
Cheney arrived at George Washington University Medical Center at 4:30
a.m., and shortly afterward, doctors performed an electrocardiogram and a
blood test. The ECG, which looks at how well the heart is beating, showed no
change from Cheney's previous ECGs. The blood test, which measures the
presence of special enzymes released by the heart during a heart attack,
showed no evidence yet of any damage. But doctors know it often takes
several hours for cardiac enzymes to show up in the blood after a heart
attack, so follow-up tests were ordered.
After a second ECG at 7 a.m. revealed minor abnormalities, Cheney's
doctors decided to take a closer look at his coronary arteries. A dye was
injected into his blood vessels and an X ray delivered the bad news: a branch
of Cheney's left descending artery — one of the three main arteries in the
heart — was about 90% blocked.
The next step was to thread a tiny surgical balloon and a thin stainless-steel
stent into the artery to forcibly widen the passage. After the balloon was
deflated, the metal mesh of the stent was left in place to keep the artery
open. During this procedure the results from Cheney's second blood test
became available. It showed a slight increase in the cardiac enzymes,
indicating that Cheney had suffered a mild heart attack after all.
Based on everything that's known so far, it seems Cheney is in pretty good
shape for someone who has had four heart attacks; there is no reason to
think he wouldn't be able to serve one or even two terms. Over the long
haul, says Dr. Christopher Cannon of the Brigham and Women's Hospital in
Boston, the goal should be to prevent future episodes through more
aggressive lowering of cholesterol and treatment with more anticlotting
agents. But it's hard to know how much more Cheney's doctors can do, since
basic questions about his treatment have not been answered.
Despite repeated requests for information, his doctors have declined to say
much about the four bypass grafts that were stitched into Cheney's heart 12
years ago. Typically, such grafts last 15 years or so before they have to be
replaced. Cardiologists trying to read between the lines of the press releases
assume his grafts must be holding up, because the stent was not placed in a
bypassed artery.
Cheney's cholesterol level has never been disclosed; doctors have said only
that it is being treated. His estimated 40% "ejection fraction," a measure of
how efficiently his heart is pumping blood, suggests that Cheney's heart is
"moderately impaired," according to Dr. Roger Blumenthal of Johns
Hopkins Hospital in Baltimore, Md., and it places him at somewhat higher
risk for another heart attack.
But, Blumenthal is careful to add, it doesn't preordain another heart attack.
"He should look at this episode as a wake-up call," Blumenthal says. Losing
weight, eating right, keeping his blood pressure low and exercising more are
all steps that should help. Most doctors also advise heart patients to
minimize stress, but stress is one thing Cheney will have a hard time
avoiding — at least for the time being.
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COVER STORY
Bush's Contested Lead
Now it goes to the courts as Gore challenges Sunday night's Florida tally
Heart Murmurs
Dick Cheney's brief but sudden hospitalization raises questions about fitness and truthfulness
Just How Bad Was It?
TIME's Christine Gorman on the vice-presidential candidate's diagnosis
Mob Scene In Miami
We look at the players behind the 'spontaneous' protest that preceded the shutdown of Miami-Dade's recount
Two-Headed Senate
With a potential Democratic victory in Washington State, the likelihood of gridlock and bickering looms large
EUROPE
Ready, Aim ... React
What can a Rapid Reaction Force from 14 E.U. countries do that NATO can't? Not much
In a Legend's Steps
Shackleton's brave Antarctic trip still awes the world. On his trail are three Britons
MIDDLE EAST
Into the War Zone
Palestinians are now directly attacking Israeli settlements. It's a new - and dangerous - tactic
THE ARTS
Full-Screen Press
French television program Arrêt sur Images entertains audiences by taking the media to task
Pictures From An Exhibitionist
Elton John has put together a big, brainy collection. Now Atlanta, his adopted city, is showing it off
The Vulnerable Woman
Jessica Lange tackles O'Neill's Long Day's Journey and shows she is more than just a great ape's date
Some More Good Men
The plot's predictable, the characters are clichés. Yet this naval drama sails through with flying colors
Fallen Angels
The stars of 'Charlie's Angels' try to soar, but the plot clips their wings
DEPARTMENTS
Techwatch
Worldwatch
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