George W. Bush was one of the most athletic U.S. presidents -- jogging, clearing brush on his Texas ranch and an avid mountain biker. But his recent heart problems were a lot more serious than previously thought, according to NBC News.
What was described at the time as a routine procedure -- a blocked artery was found during a physical exam at the Cooper Clinic in Dallas -- was potentially life-threatening, according to a report in the National Journal Monday.
Bush's doctors ordered a CT angiogram, which revealed a serious blockage in one of his coronary arteries.
At his doctor's recommendation, Bush agreed to have a stent placed to open the blockage. A stent is a metal scaffolding placed into an artery narrowed by cholesterol plaque. It restores blood flow and prevents a heart attack.
While Bush’s situation was more dangerous than reported, the presence of a heavily blocked artery doesn't mean he was at risk of an immediate heart attack, say doctors who were not involved in the former president's care.
“You can get along very well with some tight narrowings,” said Dr. Jeff Brinker, an interventional radiologist and a professor of medicine at Johns Hopkins Medicine.
When blockages develop over time, our bodies can fashion their own kinds of coronary artery bypasses, Brinker said. Other nearby blood vessels form connections that take on some of the workload of the blocked artery. Often, when a patient gets a stent you’ll see those connections almost instantly disappear, Brinker said.
The presence of a major blockage "doesn’t mean you are going to drop dead or have a heart attack the next day,” said Dr. Howard Herrmann, a professor of medicine and director of interventional cardiology at the University of Pennsylvania. “There are other factors that go into the decision of whether to put a stent in, including where the blockage is, how fast it developed, whether there were symptoms, what the stress test showed and others.”
Still, it’s possible that while Bush may not have reported any problems before the stress test, he may have had subtle symptoms. It’s not uncommon for patients, after a diagnosis, to recognize they were having symptoms, Herrmann said. “In retrospect they may have thought it was a muscle pull or heartburn, or they may have started slowing done without realizing they were doing it to prevent symptoms,” he added.
And even though Bush was physically fit, doctors say years of unhealthy food choices can lead to heart disease. "Exercise is not a guarantee against developing heart disease," said Dr. Chet Rihal, Mayo Clinic. "Therefore it is very important to keep in touch with our doctors to make sure our blood pressure, blood sugar and blood cholesterol are regularly monitored and checked."