The presidential heart attack that changed America

Heart disease is no stranger to the 白色 House.

But in a century of presidential cardiac crises, 没有一次像德怀特·艾森豪威尔1955年心脏病发作那样影响美国. The incident first shocked, then enlightened the nation. And coming right before an era of rapid scientific progress, 它突出了研究人员对心脏健康的了解程度.

The list of presidents with cardiovascular problems in the past 100 years is almost as long as the list of presidents. 富兰克林D. Roosevelt died of a stroke at age 63 while in office. 卡尔文·柯立芝在离开椭圆形办公室四年后死于心脏病，享年60岁. Lyndon Johnson had a heart attack before he ascended to the 白色 House and died of one at age 64 after he left.

66岁时，乔治.W. 布什在任期间曾因心房颤动(一种心律不齐)接受过治疗. After leaving office, Bill Clinton needed quadruple coronary artery bypass surgery in 2004 at age 58 and a stent procedure in 2010.

That's just a sampling. Eisenhower's heart attack stands out in part because it happened during an era when people were paying more attention to cardiovascular disease, but even doctors knew strikingly little about it.

"The very phrase 'risk factor' didn't exist,”医生说。. 托马斯H. 咨询公司Press Ganey的首席医疗官Lee说. “因此，你可以预测谁有风险的想法并不存在."

Lee, who wrote about 艾森豪威尔的案件 for the New England Journal of Medicine in 2020, said heart attacks at the time "came out of nowhere, and they were terrible.“即使那些被送往医院的人，死亡率也高达40%.

9月11日星期五下午，艾森豪威尔的案子开始于丹佛的一个高尔夫球场. 23, 1955. 这位1952年当选的二战英雄曾抱怨自己消化不良. 他把这种不适归咎于他的午餐——一个加了百慕大洋葱的汉堡包.

But shortly after midnight, he woke up with severe chest pain. 他的妻子玛米(Mamie)叫来了他的私人医生，医生在凌晨3点到达.m. Exactly what care the president received next is debated, but it's likely the main attempt at treatment at that point was to simply give him morphine for his pain. It wasn't until the next afternoon that an electrocardiograph was brought in to measure his heart's electrical activity.

It was only after Eisenhower awoke at 1 p.m. 这个装置被用来确认他有严重的心脏病发作.

"When you look back at his care at that time, it's really remarkable how different it is from now,”医生说。. Adrian Messerli, 他是位于列克星敦的肯塔基大学介入心脏病学科主任. Messerli co-wrote a NEJM article about Eisenhower's heart attack on its 50th anniversary.

梅塞利说，总统治疗的缓慢步伐与今天将采取的措施形成鲜明对比. Time is now known to be of the essence, 这就是为什么当人们发生这种情况时应该立即拨打911的原因 heart attack symptoms. A patient would be rushed to the hospital, examined immediately with an ECG and sent to the catheterization lab for a procedure to clear any blocked arteries.

Almost none of that was possible in 1955.

Coronary care units did not exist. 心肺复苏术或便携式除颤器对心脏骤停的人也没有效果. Those all came along a few years later, 说李, 她也是波士顿布莱根妇女医院的资深医师.

他说:“好的护理就是把病人放到床上，然后抱着最好的希望。.

由于缺乏有效的治疗，有关总统心脏病发作的线上电子游戏飞禽走兽令人恐惧. 的,你.S. 卫生局局长. 莱纳德·舍勒(Leonard Scheele)将他的震惊等同于珍珠港遭到袭击后的感受. On the Monday after the news broke, the Dow Jones Industrial Average fell 6% – a $14 billion loss that was the largest since the stock market crash of 1929.

Into this fearful atmosphere stepped Dr. Paul Dudley 白色 of Boston's Massachusetts General Hospital. 他已被军医传唤，并于周日飞往丹佛.

白色, who had helped found the American Heart Association in 1924 and had treated the likes of Andrew Carnegie and William Randolph Hearst, was "arguably the most respected physician in the country,李写道。.

Eisenhower had cleared the way for an unprecedented public discussion of his health by ordering his press secretary to "tell them everything.怀特查阅了总统的记录，咨询了他的医生，并对他进行了检查.

And before a packed news conference on Monday morning, 怀特抓住这个机会，不仅仅是讨论总统的预后, 但是要教.

那天，心脏病对数百万美国人来说不再那么神秘，也不再那么可怕了,李写道。, ，怀特告诉他们，他们可以采取措施降低风险."

白色 explained that the president's problem was not related to golf or Denver's high altitude, 正如一些人所怀疑的那样. 他详细阐述了他所谓的“冠状动脉血栓形成”的过程," where a clot prevents blood from flowing to the heart.

Speaking from the frontiers of understanding, 怀特说，心脏病发作可能与饮食等因素有关, 酒精, 烟草, exercise and family history.

Crucially, Lee said, 白色 also provided honest hope about the president's chances for recovery. 同样至关重要的是, 怀特说，心脏病发作并不意味着富有成效的生活的结束, as many thought at the time.

整个国家都在倾听. 克拉伦斯·G. Lasby wrote in his 1997 book "Eisenhower's Heart Attack: How Ike Beat Heart Disease and Held on to the Presidency," 白色 had gone to Denver as a consultant; a few weeks later, he was a national celebrity.

白色's thoughts on heart health became front-page news. Lasby 报价s him as saying, "I talked to the country during those next few weeks as I had talked to families of many private patients."

The immediate effect was to dispel the notion that heart attack survivors were doomed to lives of inactivity. 随着线上电子游戏飞禽走兽的推移, Messerli说, 白色's message also "may have improved the public's tolerance for financing cardiovascular research and medical research generally."

怀特的成就并不一定包括治愈总统.

"I think that he survived despite the care," Messerli说. “这是, it is very unlikely that any of the medical therapy that he received at the time did much to influence the outcome of his heart attack."

Eisenhower, however, did recover and won re-election in 1956. And on his own, he took several steps to help his heart health that doctors would recommend today.

Lasby writes that Eisenhower was "far ahead of the field" in following 白色's advice on the importance of exercise and a low-fat, low-cholesterol diet. 这位曾经一天抽四包烟的人在1949年突然戒掉了烟瘾. He carefully watched his weight. 在1959年总统读到降低胆固醇的饮食之后, 一位医生开玩笑说，他更担心自己的胆固醇水平，而不是高尔夫球成绩.

His cardiovascular problems did not end, though. 1957年，艾森豪威尔中风，影响了他的说话能力. 1965年的另一次心脏病发作结束了他对公共事务的参与. He died of congestive heart failure in 1969 at the age of 78.

Eisenhower did live long enough to benefit from the wave of treatments that were being developed in his final years, Messerli说. He was one of the first to benefit from a defibrillator – which can shock a heart into proper rhythm – that was introduced in 1962. 1968年，在一次住院治疗中，艾森豪威尔多次感到震惊. 梅瑟利说:“每次使用这种药物，都可以说是救了他的命。.

Late in his life he was considered for other then-new treatments, including coronary bypass surgery.

Heart attack treatment would enter a new era when balloon angioplasty – where a balloon is inserted via catheter to open blocked arteries – was successfully pioneered in 1977. 这种治疗方法, plus the arrival of clot-dissolving drugs in the 1980s, 也就是说今天, 即使是严重的心脏病发作，30天的存活率也在90%左右.

Looking back at such progress, Messerli说, makes him excited about today's emerging technologies. “想想80年后我们会在哪里，真是令人羞愧, with appropriate research and funding."

怀特今天以善良和同情教育人们心脏健康而闻名, but Eisenhower's feelings toward 白色 cooled because of what he perceived as "publicity seeking,拉斯比写道. But the author credits the president and the physician for helping to unleash "an unparalleled flood of knowledge that constituted the nation's first serious inquiry into its most devastating disease."

Writing the president in 1955, the editor of U.S. 线上电子游戏飞禽走兽 and World Report noted the many requests for reprints of its interviews with heart experts and said, "Because of your illness, the American people are better educated on the heart and its ailments than they ever have been before."

陆军博士. 托马斯Mattingly, who oversaw much of the president's treatment, 写到怀特, who died in 1973 at age 87, “今天，每一位幸存的冠心病患者都要感谢他的帮助."