Prompt care was key to San­ders’ re­cov­ery from heart at­tack

The Saline Courier - - NEWS -

Bernie San­ders suf­fered “mod­est heart mus­cle dam­age” dur­ing his re­cent heart at­tack but has since re­cov­ered well and is fit enough for the rig­ors of the pres­i­den­tial cam­paign and the White House should he win it, ac­cord­ing to let­ters re­leased Mon­day by his pri­mary care physi­cian and two car­di­ol­o­gists.

The 78-year-old Ver­mont sen­a­tor is the old­est can­di­date in the 2020 pres­i­den­tial race and had vowed to re­lease de­tailed med­i­cal records by the end of the year. His cam­paign did so the day be­fore New Year’s Eve, and the let­ters pro­vide the most de­tail it has given to date show­ing that San­ders re­ceived prompt treat­ment to re­open his clogged artery with stents fol­low­ing his heart at­tack, which oc­curred while he cam­paigned in Las Ve­gas on

Oct. 1.

After a first heart at­tack, stan­dard ques­tions in­clude the like­li­hood of an­other and whether the heart’s mus­cle was dam­aged badly enough to trig­ger later heart fail­ure. While his heart was dam­aged, San­ders has had no other symp­toms, his blood pres­sure and heart rate are “in op­ti­mal ranges,” and his heart is func­tion­ing nor­mally, with the abil­ity to ex­er­cise “well above av­er­age,” wrote his car­di­ol­o­gist, Dr. Martin Lewin­ter, of the Univer­sity of Ver­mont Med­i­cal Cen­ter.

The key test to show that was a tread­mill ex­er­cise test in which doc­tors watch for signs of trou­ble dur­ing strong ex­er­tion. San­ders’ ex­er­cise ca­pac­ity this month was “av­er­age” for a healthy man his age with­out heart dis­ease, and he was able to ex­er­cise to a level about 50% higher than men his age who do have heart dis­ease, wrote Univer­sity of Ver­mont car­diac re­ha­bil­i­ta­tion chief Dr. Philip Ades and ex­er­cise phys­i­ol­o­gist Pa­trick Sav­age in a sep­a­rate let­ter.

“At this point, I see no rea­son he can­not con­tinue cam­paign­ing with­out lim­i­ta­tion and, should he be elected, I am con­fi­dent he has the men­tal and phys­i­cal stamina to fully un­der­take the rig­ors of the pres­i­dency,” Lewin­ter wrote, also not­ing that San­ders had made an “un­event­ful” re­cov­ery from his heart at­tack.

San­ders’ heart at­tack oc­curred in an artery of­ten called the “wid­ow­maker,” and the fact that he re­ceived prompt treat­ment to re­open that blood ves­sel helps ex­plain how well he’s do­ing, said Dr. Mary Ann Mclaugh­lin, director of car­dio­vas­cu­lar health and well­ness at Mount Si­nai Heart in New York. She re­viewed San­ders’ health in­for­ma­tion.

She was re­as­sured by the ex­er­cise test­ing that San­ders’ heart is strong.

“I do not see a rea­son why he would not be able to func­tion ef­fec­tively in a high stress job,” she said. “For­tu­nately the stress test re­vealed nor­mal blood flow to his heart.”

The stents that propped open his artery do carry a risk of blood clots, so it’s im­por­tant that he stay on his blood-thin­ning med­i­ca­tion long term, Mclaugh­lin noted.

San­ders is taking ad­di­tional med­i­ca­tions that are rou­tine after a heart at­tack, in­clud­ing a blood pres­sure medicine that also can im­prove func­tion after dam­age to heart mus­cle, she noted. He also uses a statin to keep his choles­terol in check and an­other med­i­ca­tion for an un­re­lated con­di­tion, low thy­roid levels.

A let­ter from Brian Mon­a­han, the con­gres­sional at­tend­ing physi­cian in Washington, noted that San­ders was ini­tially taking ad­di­tional med­i­ca­tions after his heart at­tack but that those “were stopped based on your progress.”

“Your heart mus­cle strength has im­proved. You have never had symp­toms of con­ges­tive heart fail­ure,” Mon­a­han wrote to San­ders. “The heart cham­ber sizes, wall thick­ness, es­ti­mated pres­sures, and heart valves are nor­mal.”

He added: “You are in good health cur­rently and you have been en­gag­ing vig­or­ously in the rig­ors of your cam­paign, travel, and other sched­uled ac­tiv­i­ties with­out any lim­i­ta­tion.”

San­ders spent sev­eral days post-heart at­tack re­cu­per­at­ing in his Ver­mont home. He’s said pre­vi­ously that he had felt symp­toms for weeks that he “should have paid more at­ten­tion to,” in­clud­ing be­ing es­pe­cially fa­tigued after long cam­paign days, hav­ing trou­ble sleep­ing and some­times feel­ing a “lit­tle un­steady” at the podium while speak­ing at events.

The sen­a­tor’s staff ini­tially said stents were in­serted for a blocked artery, re­veal­ing only two days after he was first hos­pi­tal­ized that he had suf­fered a heart at­tack. San­ders has bris­tled at the no­tion that his cam­paign was less than forth­com­ing about his con­di­tion, say­ing that it re­leased as much in­for­ma­tion as it could, as fast as pos­si­ble, and that the full de­tails only came later.

San­ders is the lat­est in a string of Democrats 70 and older to re­lease med­i­cal records as age con­tin­ues to be a fac­tor in the race.

For­mer Vice Pres­i­dent

Joe Bi­den, 77, had promised to re­lease his med­i­cal records be­fore the Iowa cau­cuses on Feb. 3. A doc­tor’s re­port is­sued ear­lier this month said Bi­den is in over­all good shape and keeps his choles­terol at healthy levels with the use of a statin med­i­ca­tion. He’s also had a per­sis­tent ir­reg­u­lar heart­beat.

Also this month, 70-yearold El­iz­a­beth War­ren re­leased a note from her doc­tor say­ing that she is

“in ex­cel­lent health” and that her only ma­jor med­i­cal con­cern is an un­der­ac­tive thy­roid gland, which the Mas­sachusetts sen­a­tor eas­ily treats with med­i­ca­tion, the only kind she takes.

Michael Bloomberg’s doc­tor de­clared the 77-yearold for­mer New York City mayor to be in “out­stand­ing health,” though he is re­ceiv­ing treat­ment for sev­eral med­i­cal con­di­tions, in­clud­ing an ir­reg­u­lar heart­beat. Bloomberg also had a stent put in his heart to clear an artery in 2000.

Don­ald Trump, now 73, be­came the old­est newly in­au­gu­rated first-term pres­i­dent in Jan­uary 2017. He has been crit­i­cized for re­leas­ing only cur­sory de­tails on his health while run­ning for the White House.

On a Satur­day in Novem­ber, Trump vis­ited Wal­ter Reed Na­tional Mil­i­tary Med­i­cal Cen­ter, a stop that wasn’t listed on the pres­i­dent’s sched­ule and came just nine months after his last phys­i­cal. Trump later said he went through a “very rou­tine phys­i­cal” and blamed the me­dia for spark­ing un­founded fears that the visit meant he was ill.

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