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George Washington University Medical Center Holds News Conference on Dick Cheney's HealthAired November 22, 2000 - 2:32 p.m. ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
NATALIE ALLEN, CNN ANCHOR: We want to take you to George Washington University Hospital. An update on Dick Cheney's condition is starting.
(JOINED IN PROGRESS)
UNIDENTIFIED FEMALE: ... admitted to our hospital this morning. We have been asked by Secretary Cheney's family to discuss the events of the day. We will read a brief statement and answer a few questions.
I'd like to introduce Dr. John Williams, vice president for health affairs and dean of medicine and health sciences for the George Washington University Medical Center.
DR. JOHN WILLIAMS, DEAN, SCHOOL OF MEDICINE, GEORGE WASHINGTON UNIVERSITY MEDICAL CENTER: Thank you, Crystal.
My job is to introduce the person who's going to be answering the questions. I'm going to introduce to you Dr. Alan Wasserman, who is the president of the George Washington Medical Faculty Associates for Practicing Physicians. He's the chair of medicine, and he's a professor of medicine and cardiology.
DR. ALAN WASSERMAN, INTERIM CHAIR, DEPARTMENT OF MEDICINE, GEORGE WASHINGTON UNIVERSITY MEDICAL CENTER: Dr. Williams, thank you.
I would like to make a statement first. As I think everyone is aware, Secretary Richard Cheney came to the George Washington University Hospital emergency room with chest discomfort early this morning.
Neither his initial ECG nor his blood work indicated that he had a heart attack. After consultation with his internist, Dr. Gary Malikoff (ph), Director of the Division of Internal Medicine, Dr. Jonathan Reiner (ph), cardiologist and Director of the Cardio- Catherization Laboratory, and Dr. Richard Katz (ph), Chief of Cardiology, and when a second EKG showed minor changes, a decision was made to perform a cardiac catheterization.
The results of the catheterization showed an increased narrowing in a size branch artery, specifically, the diagonal branch of the left anterior descending artery. The rest of his coronary anatomy is completely unchanged from the previous study performed in 1996.
A decision was made to place a coronary stint in that area that showed some additional narrowing. After placement of the stint, the artery now appears normal.
Mr. Cheney has returned to his hospital room and is doing well. While there is no evidence of any new heart muscle damage on either the heart catheterization or the follow-up electrocardiograms, a second set of cardiac enzyme tests was minimally elevated.
He is in good condition and will be at bed rest for the remainder of the day, as is standard protocol in procedures such as this.
WASSERMAN: We expect a short hospital stay, and expect that Mr. Cheney will be back to normal functions without limitations in a brief period of time.
His prompt attention to his chest discomfort is what is recommended, and his approach of early intervention can serve as a role model for all Americans.
QUESTION: What do you mean by "in a brief period of time back to normal functions."
STAFF: I'll repeat the question. What did he mean by a "brief period of time" in the hospital?
WASSERMAN: We expect that he'll be in the hospital probably at this point from 48 to 72 hours. That's basically an estimate right now. But that would be the average and the standard for a patient in his condition.
QUESTION: Was he under anesthesia? And how long was the procedure?
STAFF: Was he under anesthesia? And for how long did the procedure last?
WASSERMAN: He was not under anesthesia at any time. The procedure lasted approximately two hours.
QUESTION: Did the placement or use of a stint -- did that, in fact, his coming in, prevent him from having a heart attack?
WASSERMAN: His quick reaction by coming in with the chest discomfort and the treatment he received in the emergency department certainly prevented any significant heart damage. The placement of the stint was a precautionary procedure to make sure that there'd be no further problems. QUESTION: But had he not come in, might something more serious have happened?
WASSERMAN: It is always possible if he did come in, something serious might have happened.
WASSERMAN: That is pure speculation. The fact is, he did come in, in a timely manner and therefore nothing serious did happen.
QUESTION: Were any specific stress tests done and any indication that stress may have been a factor?
WASSERMAN: No stress test was done at this time, and there's no indication that stress is a factor. Secretary Cheney certainly is used to handling all types of stress from his days in government, as well as private sector. There's no way to assess that stress had any role in this at all.
QUESTION: ... you switch from testing to treatment?
WASSERMAN: He came in approximately 4:30 this morning. After the second ECG was obtained, around 7:00 this morning, and after, again, further consultation with some of the people that I mentioned, it was then decided to go to the catheterization laboratory, and that was probably around 8:30 that decision was made.
QUESTION: And so the stem -- I'm sorry -- the stem itself was put in at what time?
WASSERMAN: The stem was put in sometime during the cath procedure, probably closer to 10:30 this morning.
QUESTION: Doctor, is the narrowing of the one artery today consistent with a clean bill of health for Mr. Cheney a matter of a few months ago? And if you know, as part of that, when he received his, quote, "clean bill of health" this summer in joining the ticket, did that include a stress test?
WASSERMAN: I don't know whether he had a stress test this summer. I'm not his personal physician.
The amount of change that we saw on his catheterization today, compared to his catheterization back in '96, is actually somewhat remarkable in the minimal amount of change that there has been.
Other than this one branch artery that shows some narrowing, the rest of his anatomy, heart function, everything about his procedure, was unchanged. That is quite remarkable and goes to speak, probably, of the care that he's been receiving and the care he's taken of himself in preventing any progression of disease.
QUESTION: If I may follow up on that, in your medical experience, would he -- Mr. Cheney -- should he have received a stress test this year in joining the ticket as part of thorough physical examination, given his history?
WASSERMAN: A stress test is one piece of information, one test that we use in patients to assess their function and assess their prognosis. It is not the test of choice for all patients.
Again, not being his personal physician, I would not want to speak whether that was appropriate or not since I don't even know at this point in time whether he had one or not.
WASSERMAN: I know he's had previous exercise tests.
QUESTION: Was Secretary Cheney awoken from sleep? And also, can you say what medicine he was on, on presentation?
WASSERMAN: I can't comment on what medication he was on, at the present time, again, because I'm not his personal physician. I don't know whether he was woken from sleep or not, but the early morning hour would indicate that that was certainly a possibility.
QUESTION: Was anything to do with the campaign schedule and/or any particular rigors of the campaign -- did this lead into this particular abnormality which he suffered? And also, were the rigors of this campaign exceptional since he has had quadruple bypass surgery in the past?
WASSERMAN: I think what is exceptional here is what I spoke to before, and that is the minimal amount of change we've seen over a considerable amount of time. It is quite unusual for a patient that has had a previous catheterization, and it speaks to him taking care of himself and probably following whatever orders he was given, as far as diet, exercise and medication he was on.
WASSERMAN: I don't believe that whatever stress there was from the campaign had any role to do in what happened today.
QUESTION: Early reports said that the intensity of pains in his shoulders. Were there any other symptoms? Nausea, a feeling in extremities, were there any other symptoms?
WASSERMAN: As far as I know, he had no other symptoms, other than the chest discomfort.
QUESTION: Well, if he had similar symptoms at all in the past couple of years, when was the last time he had any kind of chest discomfort?
WASSERMAN: I do not know of any further symptoms. I do know that certainly this symptom that he had this morning was enough to bring him to the attention of medical care, which was smart.
I would imagine that if anything like this would have occurred before, he would have done the same thing. So therefore I assume that he probably has not had anything like this in the very recent past.
QUESTION: What's the prognosis once he leaves the hospital, for recovery? WASSERMAN: His prognosis is excellent at this point in time. I would expect that he should be able to get back to normal functioning and normal activity within a few weeks at the very most. He will have no limitations and should be able to go about whatever his job is in the next few months.
QUESTION: The question here, following up on that question, is, can Dick Cheney perform the offices of vice president or, if called upon, perform the office of president of the United States?
WASSERMAN: Absolutely. I think he will have no limitations at all, from our standpoint, when he leaves here.
WASSERMAN: I think he has shown, from the campaign that he just went through, that he is a vigorous, energetic individual. And we expect, if anything, he's in better shape now, having received the stint in his coronary artery, than he was probably a few hours ago. He should have no limitations at all to his activity.
QUESTION: (OFF-MIKE) he's working on the transition now. Will this recuperation period interfere with his ability to do the transition?
WASSERMAN: No, not at all. I would expect that by this evening he will be up and around and certainly can start -- if he so chooses -- can start getting back to work.
QUESTION: What does he need to do to prevent this from happening again?
WASSERMAN: Well, what he's been doing, obviously, has worked, as I said before, and we would give the same recommendations we would give to anyone, and that is proper diet, proper exercise, and, obviously, what he has been doing has been successful.
UNIDENTIFIED FEMALE: Thank you very much, ladies and gentlemen.
ALLEN: Alan Wasserman, from the George Washington University Hospital, giving us the latest on Dick Cheney, who came to the hospital early this morning complaining of chest discomfort. He did not have a heart attack. He has had a catheterization. We're going to talk more about this procedure in a moment. But right now, he is in good condition. They expect a short hospital stay. He could be out by the weekend, 48 to 72 hours, says the doctor. And he says that, with a smile, the doctor said that Dick Cheney should able to function in any job he has in the next few months. Nobody knows quite yet what that will be, but he said he should be able to function with no limitations and he should be up and about by this evening.
So let's talk more with Rhonda Rowland, our medical correspondent -- and Stephen, of course, is here with us -- about what led to a catheterization and what does that mean about his heart is functioning.
RHONDA ROWLAND, CNN CORRESPONDENT: OK. What it sounds like they did here is they took kind of an aggressive approach, and what that means is typically, when someone has the situation that Mr. Cheney did, with the chest main, is they will either do a stress test or they'll go ahead with a heart catheterization. So what that means they go in, this person is awake, they may be just slightly sedated, and then they'll take a catheter and thread this from the groin up to the heart. They'll inject dye, and they can see the heart on an X- ray. So they can see where there is a blockage. This is very common.
And when they do this procedure, if they see a blockage, right then and there, they can take action. And typically what's done -- and the doctors didn't mention this -- but they will go in with a balloon if there is a partially blocked artery and they will open it. And once it's opened, then they can put in the stent. We heard that a stent was put in place, and we have an animation to show you what this is.
So here what you're looking at is the catheter going in and the artery is expanded, and you see that mesh device is unfolded, and this props the artery open. And so that will ensure that blood flow is getting to the heart.
And this device, the stent, is a major advance in cardiology. They came on the scene in the early 1990s, and it's been a tremendous boon, that it's really cut down on the renarrowing of the arteries. Before they came up with the stent, about half of the arteries would close within months, and this has cut it down to about 20 percent. So a major advance.
ALLEN: But as he said, he didn't -- he wasn't able to say whether Mr. Cheney coming in today prevented serious heart damage. We know he's had such a history of heart problems. But what they did today is considered, as you say, something that is progressive to do.
ROWLAND: Yes, that's right, because the artery was clearly narrowing, and if it wasn't attended to, eventually it could have possibly led to a heart attack. There's no way to, of course, know that.
But also the doctors here were able to take advantage of some very new information that they learned about last week at the American Heart Association Conference. They found out that patients like Mr. Cheney coming into the hospital, if they take this aggressive approach and they do a heart catheterization and take action right then and there, they can reduce deaths from heart disease, heart attacks by about 20 percent.
So it's really quite exciting that doctors just got this information, because until that point, they were divided. They didn't know which way to go, to take this wait-and-see approach and just do a stress test, or go ahead and do a procedure like this.
STEPHEN FRAZIER, CNN ANCHOR: In fact, you heard Dr. Wasserman there from George Washington University Medical Center almost sounding as if the secretary is a poster child for heart patients. Because of his early intervention or his seeking of early intervention, he may have prevented a lot of harm. ROWLAND: That's right, that's what they always say: if you have this discomfort, that you should go and seek medical attention immediately, as soon as you feel it, so that they can take some interventions there.
And also, I'd just like to add some more information -- this came out of the meeting last week and probably the doctors took advantage of this -- when patients get stents, they also get a blood-thinning drug. And doctors haven't known which drugs to use. There are two different ones that they've been looking at, and they found that one particular drug was clearly superior. It reduced, again, deaths and further heart attacks by about 26 percent.
So here, just a week after the American Heart Association Conference, doctors are probably taking advantage of this new information.
ALLEN: Well, we're glad you covered that conference last week so you can bring us all that information. All right. Things looking good -- thanks, Rhonda -- for Dick Cheney today, in good condition. He should be out of the hospital perhaps by the weekend and should be able to function normally.
FRAZIER: With no restrictions or limitation, Dr. Wasserman said.
So what kind of life is he likely to lead in the days and months ahead. Well, we happen to have, standing by, someone who's been through all of this, and he was in the middle of a conversation when we interrupted him to turn away.
As it turns out, David Cardwell, our analyst about the elections in Florida, has undergone the same, the very same procedure. Is that right, Mr. Cardwell?
DAVID CARDWELL, CNN ELECTION LAW ANALYST: That's correct, two years ago.
FRAZIER: And how did things turn out for you?
CARDWELL: Fantastic. It was really a wakeup call to me to make some lifestyle changes. I also had the benefit of -- this was in Colorado. I was vacationing with family. And much like Secretary Cheney, I woke up early one morning, I had some chest pains, and when it started to move into my arm, I felt it was more than just something normal and went to a hospital nearby that did a very aggressive procedure. I had the heart catheterization and then the stent put in. And I was fine. I was out of the hospital in just a couple of days.
But what was more important was the changes in diet, changes in lifestyle, the need to get on a routine exercise program. And you know, I've felt fine since.
I am on medication for it, but it's -- it certainly was not anything that caused me to be disabled for any long period of time. I was able to get right back to functioning very quickly. FRAZIER: Did you feel any sense of fragility after being through all of that? I know some people who've been through heart procedures think that they -- they really have to tread lightly for a while.
CARDWELL: Well, a little bit. You know, after you go into the emergency room and then get put in the heart trauma center and you've got a whole team of nurses and physicians working on you, you kind of realize that it's something out of the ordinary. But it did make me realize I did make some changes, and I've tried to do that since. But I don't want to go through that again.
ALLEN: Well, we're certainly glad you're doing well today and you're feeling well.
FRAZIER: Because we're going to work you a little harder.
ALLEN: Yes, just because we like you, and because, David, we need you.
So thank you, David Cardwell. We'll be talking to you some more.
Thanks for adding that story. It helps us appreciate what Dick Cheney is going through right now, and our thoughts, of course, are with him.
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