- The Washington Times - Tuesday, March 6, 2001

Vice President Richard B. Cheney experienced two "brief, mild episodes of chest discomfort" yesterday and checked himself in to a hospital where doctors reopened the same artery that caused his fourth heart attack last November.
His cardiologist, Dr. Jonathan Reiner, said last night that initial tests show Mr. Cheney, 60, did not suffer a heart attack.
He also said that the "nonemergency" medical procedure was successful, and that the vice president could be back to work as early as tomorrow.
"After an uncomplicated procedure like this, we would routinely send them home the next day and then often they return to work the following day," Dr. Reiner said. "So we'll see how he feels in the morning."
Asked for a long-term prognosis, the doctor said: "There is a very high likelihood that he can finish out his term in his extremely vigorous capacity."
But the doctor added a note of caution.
"His chance of an adverse outcome is certainly higher than someone without heart disease, but unfortunately I cannot quantify that," he said.
President Bush called Mr. Cheney yesterday afternoon to wish him well, said White House spokesman Ari Fleischer.
"During their five-minute phone call, the vice president told the president that he was feeling fine and looked forward to returning to work," Mr. Fleischer said.
The vice president, who suffers from chronic coronary artery disease, went to George Washington University Medical Center at about 3:30 p.m. yesterday. Doctors performed tests to determine the problem and found that the artery reopened in November was 90 percent closed with scar tissue.
"It's like a garden hose that starts to fill with sediment… . The effect of channeling inside the hose has been dramatically narrowed," Dr. Reiner said.
In an hour-long procedure, doctors first inserted a flexible tube into a leg vessel and snaked it to an artery supplying blood to the heart. At that point, dye was injected. The dye shows up on an X-ray or fluoroscope, showing doctors how well blood flows through the artery.
Then, in a procedure called angioplasty, doctors dilated the artery with a tiny balloon, reopening the blood vessel. Mr. Cheney was put under mild sedation and he dozed during the procedure, Dr. Reiner said.
The artery was the same one reopened Nov. 22 after Mr. Cheney suffered what doctors called "a very slight heart attack." At that time, surgeons inserted a "stent," a wire mesh tube about the size of a spring in a ball-point pen.
The stent pushes vessel-blocking plaque out of the way and reopens the artery.
Dr. Reiner said yesterday the same area of the artery had clogged up again, adding it was a "classic" example of reclosure of a vessel after a stent is inserted. He also said there is a 40 percent chance the symptom will recur.
Mr. Cheney experienced what Dr. Reiner called a "left chest twinge" Saturday while he was getting off a piece of exercise equipment, then had a recurrence Sunday afternoon and at 2 p.m. yesterday.
"The symptoms were subtle. I think what began to bother the vice president is that they recurred," Dr. Reiner said.
Doctors said the last heart attack and yesterday's symptoms were completely different.
"In November, he had had a rather strong and prolonged, for about an hour, episode of chest discomfort," Dr. Reiner said. "This was really a much milder and very brief on the order of just, literally, three to five minutes of pain, twice today, which was actually quite different in character than the discomfort he had in November."
Mr. Cheney had his first heart attack in 1978, at age 37. At that point, he dramatically cut back on his three-pack-a-day smoking habit. Mr. Cheney had a second attack in 1984 and a third in 1988. All were described as mild.
In August 1988, Mr. Cheney underwent the bypass surgery because of arterial blockages.
Dr. Reiner said the vice president now exercises for a half-hour four to five times a week and has been on a "rather, to say it mildly, rigorous diet… . He's lost a significant amount of weight."
In an interview Friday with The Washington Times, Mr. Cheney said he was living a disciplined life in his new home.
"With the house and the job comes a Navy steward who takes care of all the groceries. So my wife gets a proposed menu every week that sets down meal by meal and lays it out, and she checks off what she wants to have, makes some changes, and they fix it.
"But somebody else is in control of your food supply. It's been good for my waist line so far. They don't let me near the menu."
That is different from how he used to eat, he said.
"I used to be able to hop in the car and run down to McDonald's, and I can't do that any more." He did, however, admit to one indulgence he and his wife share: "We've gotten addicted to Starbucks over the years. We always start the morning with a latte."
With the job and the house comes another perk: constant medical attention.
"One of the things about this job is you've got a doctor who follows you around all the time," he told The Times. "Not anything I planned on, but you feel like you're being carefully watched at all times."
When Mr. Cheney suffered his "very slight heart attack" after the November election, Mr. Bush at first insisted his vice-presidential running mate had not had a heart attack at all. But doctors later confirmed he had.
That night, Mr. Cheney called in to CNN's "Larry King Live."
"I feel good," he said and even made light of the nation's electoral morass, saying that doctors "found no pregnant chads" in the artery.
That heart attack his fourth came after the Florida Supreme Court ruled that election officials could continue hand counts in predominantly Democratic counties.
But Mr. Cheney told Mr. King the electoral fight played no role in his heart attack.
"I have not found these last two weeks that stressful," the former defense secretary said. "My time in the Pentagon and in the Persian Gulf war was much more stressful."
Mr. Cheney attended a birthday party for Alan Greenspan on Sunday night, capping a weekend in which he and his wife moved into the vice president's residence at the U.S. Naval Observatory. He also appeared on two Sunday talk shows.
But doctors said yesterday stress likely played no role in the latest episode.
"This is a response to the stent. I think stress plays very little role in this," Dr. Reiner said.
Mr. Cheney's heart problems were a consideration even before he became Mr. Bush's running mate July 24. At that time, doctors gave him a clean bill of health.
The Bush campaign provided the media with letters from those doctors outlining the former defense secretary's health history and concluding that he was "in excellent health" and "up to the task of the most sensitive public office."
Well-known and liked in Washington since his days as President Gerald Ford's White House chief of staff in the 1970s, Mr. Cheney served 10 years as Wyoming's only U.S. representative. He then served as defense secretary under Mr. Bush's father, and in 1991 directed the U.S. military operation to expel an Iraqi occupation army from Kuwait.
Two years after leaving the government in 1993, Mr. Cheney became chief executive of Halliburton, an oil company, before joining Mr. Bush on the Republican ticket.

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