Cheney has surgery to clear artery

WASHINGTON — WASHINGTON - Vice President Dick Cheney, who has suffered four heart attacks, checked himself into a hospital yesterday after complaining of chest pains and underwent surgery to clear a partially blocked artery.

Doctors said Cheney would remain overnight at George Washington University Hospital and probably be released today. A White House spokesman said that Cheney and his doctors would then decide when the vice president will return to work.


Dr. Jonathan Reiner, Cheney's cardiologist, said that "as of now," the vice president did not appear to have suffered another heart attack. But Reiner said a final determination would have to await further tests.

The 60-year-old vice president suffered his most recent heart attack in November, after which Reiner and other physicians inserted a small wire-mesh tube, known as a "stent," to unclog a coronary artery. The area around this stent had became blocked again and caused Cheney to suffer four mild bouts of chest pain since Saturday, doctors said.


Doctors described the pain this time as "much milder and very brief" compared with the chest pains Cheney suffered in November during what doctors called a "very slight" heart attack.

There is about a 40 percent chance that the same artery will narrow again in the next few months, Reiner said. But the doctor said he saw no reason to think that the vice president could not resume his full duties.

"I wish I could predict the future," Reiner said. "I think there's a very high likelihood that he can finish out his term in his extremely vigorous capacity."

In the first few weeks of the Bush administration, Cheney has become an extraordinarily active vice president and an influential adviser to the president on numerous matters, notably on national security, relations with Congress and staffing. As a former defense secretary who served under Bush's father, Cheney wields particular influence over issues involving defense and foreign policy.

Call from Bush

Last night, Bush placed a five-minute call to Cheney in the hospital. White House officials reported that during their conversation, Cheney told Bush that "he was feeling fine and looked forward to returning to work."

Aides said that since his heart attack in November, Cheney has felt generally healthy, lost weight, kept to a rigorous regimen of diet and exercise, and worked out several times a week on fitness equipment at home.

Here is how doctors and aides described the complications involving Cheney's health that surfaced over the past several days:


On Thursday, the vice president had what doctors described as a routine follow-up exam, in which he underwent an electrocardiogram. Physicians said they saw nothing to concern them.

On Saturday, Cheney suffered his first chest pains, shortly after working out on the exercise equipment at the vice presidential residence. He suffered a second episode of pain on Sunday afternoon.

Earlier Sunday, when Cheney was asked during an interview with CNN how he was feeling, he did not mention the chest pain he had experienced a day earlier. Instead, he responded: "Well, I feel great. I am well-behaved. They've taken control of my food supply. So, I'm trying to do all those things you need do to be a responsible individual with a history of coronary artery disease and somebody who's 60 years old. So far, so good."

The vice president attended a birthday party for Federal Reserve Chairman Alan Greenspan on Sunday night.

Yesterday, Cheney suffered two additional waves of pain, one in the morning and one in the early afternoon. Aides said Cheney had kept to his schedule, holding several morning meetings, including one with a group of journalists at noon, then meeting with Bush.

But by midafternoon, after telling the president about his chest pain and speaking with his doctors, Cheney traveled by motorcade from the White House to the hospital, where he walked in under his own power at 3:30 p.m.


Later in the afternoon, Bush was peppered with questions from reporters about Cheney's condition. The president confirmed that the vice president had gone to the hospital, describing it as a "precautionary measure."

Playing down concerns

White House officials moved hastily yesterday to play down concerns, releasing a statement in which Mary Matalin, a senior advisor to Cheney, said that doctors were performing a "nonemergency precautionary procedure."

Last night, at George Washington University Hospital, Reiner presided over a news conference in which he was joined by other doctors. They answered questions at length and in detail, in contrast with a session with reporters in November, when the same doctors failed to mention that Cheney had suffered his fourth heart attack.

Reiner said that Cheney's procedure, known as an angioplasty, took about 90 minutes and involved inflating a tiny balloon within Cheney's stent to clear the blockage that had formed. He described the procedure not as an emergency but as "urgent."

"We knew in November there would be a 20 percent likelihood of this" occurring after the insertion of a stent, Reiner said. "So we watched him very carefully."


But the doctor distinguished between November's heart attack and the chest pains of the past few days, which he said probably occurred because of the stent itself and not as a result of any further deterioration of Cheney's artery. Reiner said the body sometimes responds to a stent as an intrusion, setting off an inflammatory response that can eventually cause a new blockage.

'Affects millions of people'

"He has chronic coronary artery disease," Reiner said of the vice president. "This is what affects millions of people."

Reiner praised Cheney for keeping to a strict exercise regime and rigorous diet established after his heart attack in November.

"He's been terrific," Reiner said. "The vice president exercises about a half-hour, four to five times a week. He uses two pieces of exercise equipment, gets his heart rate up, gets a good bead of sweat going."

Reiner also said that Cheney has lost "a significant amount of weight," though he did not specify how much.


One White House official said the vice president rarely eats breakfast - having only coffee - and eats mostly salad or chicken dishes for other meals. He generally steers clear of sweets and red meat.

Cheney suffered his first heart attack in 1978 and subsequent ones in 1984 and 1988. He also underwent successful bypass surgery in 1988.

The vice president's heart attack in November came during the rancorous Florida election dispute. But just after leaving the hospital, Cheney quickly resumed full duties leading Bush's transition team.

White House officials have brushed aside any questions about whether Cheney is fit for office, pointing to doctors who have cleared him to serve in high office.

The 25th Amendment to the Constitution holds that if the vice presidency ever becomes vacant, the president shall appoint a successor who must be approved by Congress.

The amendment was used twice shortly after it was ratified in 1967. Vice President Spiro T. Agnew resigned in 1973, after which President Richard M. Nixon selected Gerald R. Ford as his replacement.


The next year, Nixon resigned and Ford became president. Ford then chose Nelson A. Rockefeller as his vice president.

Sun staff writers Jonathan Bor and Ellen Gamerman contributed to this article.