Taming the No.1 Killer: Heart Disease

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Doctors attack heart disease with new techniques and potent drugs

Charles Weiner, 45, was trudging through Boston's snowy streets one night when he suddenly felt a gripping pain in his chest. In the previous eight years he had had two similar experiences, but after thorough physicals, including blood tests and electrocardiograms, doctors could find nothing wrong with his heart and attributed the pains to a mild gall bladder attack or chest muscle strain. This time, though, Weiner was given a new diagnostic test. Doctors injected a radioactive substance into his bloodstream, then took pictures of his heart with a special camera that detects radioactivity. The pictures revealed that his heart was not getting an adequate supply of blood, and further tests showed that the coronary arteries were blocked in several places. Weiner underwent bypass surgery, which eased his discomfort and may have prolonged his life.

Dana Wilson, 41, a lumber company manager in Mehama, Ore., had been taking drugs to control the occasional irregular beating of his heart following a massive heart attack. But the treatment proved unsuccessful; one day several months after the attack, his heart began to race, reaching 250 beats per minute before returning to normal. Doctors turned to an innovative method of studying arrhythmias. They threaded electrodes into his heart and electrically stimulated the tissue to induce the erratic beating. Trying different drugs, they learned that none would be helpful in treating Wilson's condition. But by moving the electrodes around, doctors located the areas of heart tissue that seemed to be generating the faulty rhythms. Last April surgeons operated and removed the suspect tissue.

David Clendenen, 58, an electrical contractor in Sacramento, had never had any indication of heart trouble. But one morning last March, he suddenly felt "like there was an elephant sitting on my chest." Realizing he was having a heart attack, he called for help and was rushed to the hospital by ambulance. Emergency room physicians stabilized his condition and transferred him to a special laboratory for a delicate experimental procedure. A long, thin plastic tube was inserted into an artery in his leg and gently pushed through the blood vessels all the way up into the aorta to the coronary arteries. A radiopaque substance was injected into the coronary vessels, and X-ray pictures were taken, revealing a blood clot. Doctors infused an anticlotting drug through the tube. Within an hour, the clot had dissolved, blood flow was reestablished, and Clendenen was spared extensive heart damage.