Sometimes we don't know how far we've come until we look back at where we’ve been. Once a heart attack was a likely death sentence; if you survived, you were often crippled for life – oddly enough, sometimes due as much to the “therapy” of the time than the heart attack itself.
Three leading heart specialists recently discussed how the heart attack has been tamed as they reviewed the past, present, and future of cardiac care. http://bit.ly/6KTaQr However, my favorite example of just how far we’ve come is the story of a former President. I first heard this from Dr. William W. O'Neill of the University of Miami, Florida, and I am now adding additional details here.
In 1949, General Dwight Eisenhower had finished conquering Europe, beaten the Nazi Empire, and become one of the most recognized people in the world. He was a heavy smoker and that year he started having chest pain. His doctor told him to quit smoking and the general successfully lowered his cholesterol. The changes seemed to work; he was healthy enough in 1952 to seek and win the Presidency of the United States. Then in late September, 1955, President Eisenhower complained of chest pain on the 9th hole during an afternoon of golf. At that point, he thought he had just eaten too many onions on his hamburger at lunchtime.
He was staying with his mother-in-law in Denver and shortly after midnight, he woke up with severe chest pain. He asked his wife, Mamie, for milk of magnesia, but she was concerned enough to call his personal physician, who arrived around 2 a.m. President Eisenhower had a history of diverticulitis, a fairly common and sometimes painful digestive system problem. So, Dr. Howard Snyder concluded his patient’s symptoms were most likely due to upper gastric pain.
At about 3:00 in the morning, however, the President took a turn for the worse; he became ashy, sweated profusely, and for about 10 minutes Dr. Snyder couldn’t feel a pulse. He improved a little, but by 7:00 AM a call was placed to Fitzsimmons Army Hospital requesting an electrocardiogram. Today, this common test is easily administered and the ECG unit can be wheeled around a room using one hand; but, back then, it was so big that it had to be delivered on a truck. The ECG showed that the President had suffered a large heart attack.
Vice President Richard Nixon decided to call in a civilian heart specialist "because we cannot overlook the fact that many people in the country might have more confidence, however unfounded, in a civilian specialist of national reputation." There was consensus to consult Dr. Paul Dudley White of Massachusetts General Hospital in Boston, arguably one of America's foremost cardiologists. The heart attack led to President Eisenhower being hospitalized from August until mid-October.
(As an aside, on Monday morning, just 2 days after the President’s heart attack, Wall Street panicked and stock prices went into a tailspin. By the end of the day, the Dow Jones had dropped by 6% — a paper loss of $14 billion, the largest decline since the crash of 1929 and one that would exceed those following the assassination of President John F. Kennedy and the shooting of President Ronald Reagan.)
In the mid-1950s, the treatment of MI was 12 weeks of bed rest followed, hopefully, by recuperation. Unfortunately, 25-30% of people suffering such a heart attack died back then. One reason may have been the 12-weeks of hospitalization! Today, we know it is best to get people up quickly after a heart attack rather than let them lie in bed becoming more out-of-shape with each passing week. President Eisenhower survived the initial heart attack, including his long period of bed rest! -- but subsequently died in 1965 having been hospitalized at Walter Reed Hospital for months due to recurrent ventricular fibrillation and angina.
Today, President Eisenhower’s problem would have been fixed promptly, either with angioplasty or surgery, and he would have been in the hospital for 2 days. That is a clear example of where we've been with the treatment of heart attack compared to where we are today.
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