WASHINGTON -- Harry M. Whittington, the 78-year-old hunter accidentally shot by Vice President Dick Cheney, was back in intensive care yesterday after suffering a mild heart attack, as questions continued to swirl around the White House's handling of the incident.
Doctors treating Whittington said a shotgun pellet lodged in his chest had triggered what they described as a "silent heart attack." His condition remained stable, said doctors at at the Corpus Christi, Texas, hospital where he has been treated since the shooting Saturday.
Cheney, who as of last night had yet to comment publicly on the accident, was quoted in a statement from his office as saying that he had spoken with Whittington after learning of his condition and that "his thoughts and prayers" are with the Austin attorney.
Doctors who briefed reporters at an afternoon news conference outside Christus Spohn Hospital Corpus Christi-Memorial said Whittington did not experience chest pains or other classic symptoms of a heart attack. They said the pellet, which they had decided to leave in place rather than remove, had caused inflammation of the heart muscle that caused a temporary blockage of blood flow.
Dr. David Blanchard, chief of emergency medicine at the hospital, said doctors were "very, very optimistic" that Whittington would make a full recovery.
Still, the heart attack revealed that Cheney's misfire, first regarded as more embarrassing than life-threatening, had potentially put his victim's health in greater danger, after doctors and White House officials had initially described Whittington as cheerfully on the mend from minor injuries.
It also derailed a concerted White House effort to move past the hunting episode, which has tarnished Cheney's image and highlighted his penchant for secrecy, while thrusting Bush's top aides, including press secretary Scott McClellan, into a tug of war with the news media.
Cheney's office - under blistering fire for failing to make a public announcement about the shooting - reversed course and issued a detailed statement about his concern for Whittington.
It recounted a phone call Cheney made to Whittington after learning of his condition, in which the vice president wished him well "and asked if there was anything he needed." Cheney "said that he stood ready to assist," the statement said.
"Mr. Whittington's spirits were good, but obviously his situation deserves the careful monitoring that his doctors are providing," the release said
Doctors said Whittington was expected to remain in the hospital for a week for treatment and observation.
Doctors in Washington, whom Blanchard described as White House physicians, have been consulting with cardiologists at Christus Spohn. Blanchard said they had agreed that it would be in the elderly patient's best interests to treat him with "medical therapy," rather than surgery, "with all the attendant risks of anesthesia [and] the possibility of all other things that could happen."
Cheney learned of the change in Whittington's condition yesterday morning and watched part of the televised hospital news conference, the statement from his office said. After the briefing, he placed a call to Whittington.
Even as the White House struggled for a second straight day to defend its handling of the shooting, McClellan continued to withhold details. He was informed of Whittington's heart troubles before his televised briefing and before the Corpus Christi news conference in which they were disclosed but did not mention the developments during the 27-minute exchange, which was dominated by questions about the hunting accident.
"You're welcome to continue to focus on these issues," McClellan told reporters. "I'm moving on."
McClellan later said he did not reveal the change in Whittington's condition because "it's not appropriate for me" to do so. "I'm not his doctor; that's for his doctor to talk about." He also said there were "privacy issues" preventing him from commenting.
As the focus turned to Whittington's health, new details continued to emerge about what took place on the 50,000-acre southeast Texas ranch where the accident occurred.
Katherine Armstrong, a lobbyist whose family owns the ranch, indicated in interviews that she and members of her family, not Cheney, had decided to inform the public about the incident.
After making that decision over breakfast Sunday morning, she and her mother, Anne Armstrong, a former top Republican official, "ran it by" Cheney, Katherine Armstrong told The Dallas Morning News. She added that Cheney "said something along the lines of, 'You all do whatever you are comfortable with.'"
Katherine Armstrong has lobbied the Bush administration on agriculture issues and lobbied the White House last year on South Korean policy on behalf of South Korean clients, according to federal records. Other guests present for the hunting party included Pamela Willeford, the U.S. ambassador to Switzerland, and her husband George Willeford III, major donors to Bush.
The sheriff's office in Kenedy County, where the Armstrong Ranch is located, issued a news release about Saturday's incident saying that "there was no alcohol, or misconduct involved" and that "this department is fully satisfied that this was no more than a hunting accident."
Carlos Valdez, the district attorney who prosecutes criminal cases in Kenedy County, said he had yet to speak with sheriff's officials but is satisfied with what he knows of their investigation.
"I haven't seen anything that indicates a need for further investigation as of this point," Valdez said.
Valdez said his office is concerned about Whittington's well-being, and that if the man were to die, he would "ask the sheriff for a copy of his report and a copy of his investigation for us to review to see if any further action is necessary. That's the only thing different that we would do."
In Corpus Christi, doctors said they had performed a cardiac catheterization on Whittington, a procedure used to discover whether arteries around the heart are blocked and there has been damage to heart function.
Johns Hopkins University cardiologist Rick Lang said the patient probably has a good prognosis. This kind of problem usually resolves on its own within one or two weeks, he said.
Heart attacks that produce no outward symptoms are "fairly common," Lang said, accounting for up to 25 percent of all heart attacks, according to a recent study. These injuries are usually discovered after the heart attack, when an EKG reveals that the heart's pattern of electrical activity has changed.
Doctors were unsure precisely where the birdshot near Whittington's heart had lodged, Blanchard said.
Dr. Mandeep Mehra, chief of cardiology at the University of Maryland School of Medicine, said the pellet might have ended up in the pericardium, the heart's protective covering. If so, it could have inflamed the covering, and inflammation can spread to the heart's chambers.
"This can lead to rhythm disturbances," known as atrial fibrillations, he said. He said they usually subside within 48 hours.
Lang and Mehra agreed with Whittington's medical team that removing the pellet is probably not the best course.
"Trying to take it out is more usually hazardous than leaving it alone," Mehra said.
"We've seen this often," he added. "The treatment is often relatively conservative. The prognosis is generally pretty good."
Sun reporters David Kohn and Brad Olson contributed to this article.