Democratic Primaries
Related: About this forumDid Bernie Sanders Have a Heart Attack?
A 78-year-old man with a medical history of gout and diverticulitis comes to the emergency department after developing chest discomfort while at a work function.
The patients overall clinical scenario is concerning enough that he is admitted to the hospital, where interventional cardiologists urgently perform a procedure called a cardiac catheterization. When the doctors inject dye into the major coronary arteries that supply blood to the heart, they find that one of them is so severely blocked that they must immediately place two stents in an effort to restore normal blood flow and hopefully prevent cardiac tissue around it from dying.
Based on the information his campaign has released, this scenario seems to be what happened to Bernie Sanders on Tuesday evening. Without a close look at Sanders medical chart, its impossible to make a definitive diagnosis, and I have not reviewed the details of his case other than what has been reported to the media by his campaign. But even the scant information we havethat he had stents inserted overnight following an acute cardiac episodeis enough to be able to say: This was very likely a heart attack.
I asked the Sanders campaign directly if they could confirm that this was or was not a heart attack. They declined to comment on the record. On Wednesday evening, the Wall Street Journal ran a story that originally stated a spokesperson for Sanders said the senator didnt suffer a heart attack, but that story was later updated to remove that assertion. The story now states that the spokesperson said more tests would be run to determine that diagnosis.
A myocardial infarction, the medical term for a heart attack, is defined as an acute injury to the muscle of the heart, accompanied by clinical evidence of inadequate blood supply. This is usually confirmed with a blood test called a cardiac troponin that detects evidence of the damage (this testing takes hours, not days). The threshold that must be reached to raise a doctors suspicion of a heart attack is not high. New chest pain or pressure certainly suffices. Pain or new shortness of breath, whether with exertion or at rest, also suffices. But even less obvious symptoms such as sweating, jaw pain, or sudden arm tingling are enough to spur an immediate investigation.
https://slate.com/technology/2019/10/bernie-sanders-heart-attack-diagnosis-stents-chest-pain.html
primary today, I would vote for: Joe Biden
TidalWave46
(2,061 posts)One pice people are looking over is that he has been sick. While more common in women, its a sign of an ongoing cardiac event(heart attack).
When someone feels sick for a couple of weeks and then goes to the hospital with chest pains and has two stents put in, its fair to assume it a heart attack. Pretty much guaranteed if it was a woman.
primary today, I would vote for: Joe Biden
NurseJackie
(42,862 posts)primary today, I would vote for: Joe Biden
ritapria
(1,812 posts)Quite an appropriate last name ..The author is oozing with empathy and compassion , don't you think ? The issue he raises is legitimate and the Sanders Campaign should be fully transparent on whether he has suffered a heart attack .The tone conveyed by the author is however rather bone-chillingly analytical
primary today, I would vote for: Undecided
Fla Dem
(23,591 posts)Jeremy Samuel Faust, MD MS MA, is an emergency physician at Brigham and Women's Hospital and an instructor at Harvard Medical School.
primary today, I would vote for: Joe Biden
ritapria
(1,812 posts)And he hasn't examined Bernie so he does not know of where he speaks .He sounds cold- blooded and I don't like that
primary today, I would vote for: Undecided
LanternWaste
(37,748 posts)"The tone conveyed by the author is however rather bone-chillingly analytical..."
Hence, you take issue with objectivity displacing emotive bias in reporting? I imagine there are plenty of puff-pieces out there to placate any desire for preferential reporting; but I don't think it's the job of an objective analysis to replace get-well-soon cards.
primary today, I would vote for: Joe Biden
cwydro
(51,308 posts)primary today, I would vote for: Joe Biden
BlueMississippi
(776 posts)primary today, I would vote for: Joe Biden
pnwmom
(108,959 posts)The medical truth, according to this ER physician and instructor at Harvard Medical school, is that his sudden symptoms mean he either had a heart attack, or unstable angina -- which can have outcomes as serious as a heart attack.
It's not this physician's job to sugarcoat the facts for the public.
primary today, I would vote for: Joe Biden
ehrnst
(32,640 posts)False dilemma.
He's displaying the calm demeanor of medical professional who and that means being neither of those things.
Your characterization of a physician speaking about Bernie's condition in clinical terms may not be accurate, because he's talking about Bernie, whom you have a lot of emotional responses to.
Many Trump supporters react the same way when medical professionals calmly point out symptoms of mental illness issues in him.
primary today, I would vote for: Joe Biden
Act_of_Reparation
(9,116 posts)primary today, I would vote for: Undecided
cwydro
(51,308 posts)primary today, I would vote for: Joe Biden
Act_of_Reparation
(9,116 posts)He did not see the patient. He did not treat the patient. He does not have access to the patient's history, their charts, or their test results. He offers no insight or expertise beyond his anecdotal experience as an emergency physician (note, not a cardiologist).
Of course he offers a perfunctory disclaimer, and I'm sure people will claim he's "just asking important questions". The problem is saying "I can't say anything for certain" kind of loses its effect when you're seemingly certain enough of it to write a fucking article for Slate.
primary today, I would vote for: Undecided
cwydro
(51,308 posts)Which was incorrect.
primary today, I would vote for: Joe Biden
Saviolo
(3,280 posts)She was 83 at the time. She also had stents put in. The doctors came short of calling it a heart attack, they called it a "coronary event." It wasn't quite a serious as a heart attack, though it was still a serious situation, of course. She's on a few new drugs now, but she's still healthy and has gone back to her active lifestyle.
primary today, I would vote for: Joe Biden
spooky3
(34,407 posts)And he is still doing great in his late 80s.
primary today, I would vote for: Joe Biden
comradebillyboy
(10,128 posts)primary today, I would vote for: Joe Biden
hlthe2b
(102,138 posts)it is not in any way NECESSARILY career (Presidency)-ending. I say that as one who is not supporting Bernie , but who wishes him well and think he deserves a fair appraisal.
Perhaps the best way to help put things in perspective is to remind you of what SHOULD have been career-ending in its significance and severity , but clearly was not:
Vice President Dick Cheney's history of heart problems started in 1978, when he suffered his first of four heart attacks at the age of 37.
The following is a summary of Cheney's heart problems:
1978: Dick Cheney suffers his first heart attack. The incident does not sideline Cheney, as the former White House chief of staff wins the first of five terms to Congress that same year.
1984: Cheney has another heart attack while serving as Wyoming's lone U.S. representative. Doctors consider the heart attack minor, like the 1978 incident, and Cheney soon heads back to work, eventually representing the Republicans as minority whip in the House.
1988: An attack in August -- Cheney's third before his 48th birthday -- leads to quadruple bypass surgery. But the congressman's condition stabilizes throughout the 1990s, with no official reports of health problems. He has his last comprehensive heart checkup in 1996, without having another for four years.
November 22, 2000: With the presidential election hanging on a few hundred votes in Florida, Cheney checks into George Washington University Hospital with chest pains. Doctors insert a coronary stent to prop open a narrowed artery after what Cheney calls "a very slight heart attack." Doctors say Cheney should be able to resume all his normal activities.
March 5, 2001: Cheney checks himself into George Washington University Hospital with chest pain and discomfort. The vice president undergoes an urgent procedure to re-open the blocked heart artery treated in November, returning home after an overnight stay. With advisers saying his heart has not been damaged, Cheney soon resumes his busy schedule.
June 29, 2001: Cheney says he will undergo tests to determine whether he needs a "pacemaker plus," a device to normalize an irregular heartbeat. Cheney calls the procedure "an insurance policy" given his history of heart problems.
June 30, 2001: Doctors say Cheney's prognosis is "terrific" after he has surgery to implant a device to monitor his heart rhythm and slow it down if necessary. Cheney leaves the hospital that afternoon.
February 8, 2002: Cheney completes a "routine" physical to allow doctors to check the status of his heart pacemaker device. No complications were reported.
May 11, 2004: Doctors give Cheney a clean bill of health after his annual heart checkup. They find that his pacemaker had detected no irregular heartbeat, a spokesman said. During the visit, the vice president underwent an EKG, and echocardiogram, a stress test, a regular physical and a check of his pacemaker.
https://www.cnn.com/2004/ALLPOLITICS/11/13/cheney.timeline/
and of course, Cheney had a 2012 heart transplant at age 71
https://www.cnn.com/2012/03/24/politics/cheney-transplant-surgery/index.html
primary today, I would vote for: Joe Biden
RandySF
(58,511 posts)But will he continue the same crazy travel schedule?
primary today, I would vote for: Joe Biden
hlthe2b
(102,138 posts)I hope he does what feels right to him. Life is short and one can not let public expectations decide for you what you do IMO.
primary today, I would vote for: Joe Biden
musicblind
(4,484 posts)I feel like sometimes we ask too much of our politicians.
Too little in some areas (policy and action) and too much in others (campaign and travel).
primary today, I would vote for: Joe Biden
left-of-center2012
(34,195 posts)My ex had stents put in.
It's not a heart attack.
"Stents are placed to reduce the risk of heart attack.
They are common devices, placed in about 1 million Americans a year, says John McPherson, a cardiogist at Vanderbilt University Medical Center in Nashville."
https://www.google.com/search?q=how+many+Americans+a+year+have+stents+put+in+their+heart&gs_ivs=1#tts=0
primary today, I would vote for: Joe Biden
hlthe2b
(102,138 posts)on blood testing. That's why I think the campaign backed off from stating absolutely no heart attack because (likely) they were told by his health care team that it is too early to say absolutely, pending these tests (and perhaps others).
But, yes, you are right that enough coronary artery occlusion requiring stints can occur without triggering a myocardial infarction (heart attack) if caught early enough. By clearing the blockage, the risk of future heart attack is most often dramatically reduced.
primary today, I would vote for: Joe Biden
pnwmom
(108,959 posts)and required stitches. Too bad he got them in a walk-in clinic. He should have had a full physical then, to make sure there wasn't a serious reason for his fall. At his age there often is.
primary today, I would vote for: Joe Biden
primary today, I would vote for: Joe Biden
BlueMississippi
(776 posts)They are placed only when there is angiographic evidence of a severe blockage. Usually the patients do have a small MI by the time the stent is placed and they are placed to reduce further tissue necrosis.
primary today, I would vote for: Joe Biden
left-of-center2012
(34,195 posts)primary today, I would vote for: Joe Biden
drray23
(7,619 posts)Why do you find that so surprising ?
primary today, I would vote for: Joe Biden
left-of-center2012
(34,195 posts).
primary today, I would vote for: Joe Biden
thesquanderer
(11,972 posts)primary today, I would vote for: Joe Biden
pnwmom
(108,959 posts)with stents didn't have a heart attack. Many, many of them have. And Bernie's diagnosis is not clear. From the article:
primary today, I would vote for: Joe Biden
left-of-center2012
(34,195 posts)primary today, I would vote for: Joe Biden
pnwmom
(108,959 posts)Many people get stents AFTER they've had a heart attack. Luckier people get them to prevent a heart attack.
In Bernie's case, no one can say whether he had one or not, because his campaign isn't saying.
primary today, I would vote for: Joe Biden
left-of-center2012
(34,195 posts)primary today, I would vote for: Joe Biden
pnwmom
(108,959 posts)Notwithstanding your ex.
primary today, I would vote for: Joe Biden
left-of-center2012
(34,195 posts)primary today, I would vote for: Joe Biden
NurseJackie
(42,862 posts)I expect that he'll soon announce that he's quitting his campaign.
primary today, I would vote for: Joe Biden
left-of-center2012
(34,195 posts)primary today, I would vote for: Joe Biden
NurseJackie
(42,862 posts)primary today, I would vote for: Joe Biden
thesquanderer
(11,972 posts)between Warren and Biden (30% Biden, 28% Warreen).
https://morningconsult.com/2020-democratic-primary/
primary today, I would vote for: Joe Biden
cwydro
(51,308 posts)I imagine theyre talking over all the details even now.
primary today, I would vote for: Joe Biden
NurseJackie
(42,862 posts)Somebody's going to have to do a shitload of finessing... and wordsmithing... and massaging the details... if they want this to come of as being something that's no-big-deal.
I can tell you one thing... this was NO "routine outpatient procedure" as some have suggested. This is serious and deadly stuff.
Nobody goes to a corner doc-in-the-box clinic to get stents inserted. There's a REASON he went to a HOSPITAL and there are reasons he stayed overnight.
Has he even been released yet?
primary today, I would vote for: Joe Biden
cwydro
(51,308 posts)Good question as to whether hes been released. I havent heard.
Usually wed get some version of hes resting at home.
primary today, I would vote for: Joe Biden
Hortensis
(58,785 posts)Myocardial ischemia will cause chest pain, but the term "heart attack" is most typically used to describe an event that causes permanent damage to cardiac tissue. It can be anywhere from small to devastating.
Ischemia results from reduced oxygenation of heart muscle from reduced blood flow but doesn't have to mean permanent damage. The stenting presumably fixed the circulation problem.
So, no at this point. How long it takes him to return to fairly normal activities should be a clue. Even minor heart attacks take time to recover from. In contrast, if it weren't for the inherent danger, many stentings could be done outpatient instead of done in-hospital with overnight stay for monitoring.
primary today, I would vote for: Joe Biden
BlueMississippi
(776 posts)This was the final straw (I backspaced the other common euphemism when I realized it would be insensitive)
primary today, I would vote for: Joe Biden
Hortensis
(58,785 posts)the dreadful 2016 disaster, his tepid attempts to expand his following this time, and his decades of rejection of the Democratic Party, including the toxic comparisons he's been making of Democrats to Republicans all through this campaign, I suspect he's been pursuing more achievable goals than the distant gold ring of the nomination itself.
primary today, I would vote for: Joe Biden
BlueMississippi
(776 posts)and support third party to help Trump win.
primary today, I would vote for: Joe Biden
Hortensis
(58,785 posts)Sometimes we ourselves don't really know or won't admit, and it's our actions that tell truths we wouldn't if we could.
primary today, I would vote for: Joe Biden
BlueMississippi
(776 posts)The fact that the campaign has not released the troponin levels speaks volumes. If his troponin had been normal, they would have broadcast it saying "look, it was not a heart attack!"
primary today, I would vote for: Joe Biden
AncientGeezer
(2,146 posts)primary today, I would vote for: Undecided
BlueMississippi
(776 posts)The secretiveness around this common issue speaks volumes.
primary today, I would vote for: Joe Biden
AncientGeezer
(2,146 posts)No ethical Doc dose a diagnosis without an exam.
primary today, I would vote for: Undecided
BlueMississippi
(776 posts)BS is a public figure, running for POTUS. Different rules apply.
BS team has been secretive about his condition because they don't want people to know how bad it is. Release the EGG. Release the CK and Troponin levels. Release the angiogram results. Let the cardiologist do a presser and inform the public.
Why not? Because BS is likely to be a ticking time bomb and they don't want voters to know about it. Worse, they want voters to think everything is A-okay which is disingenuous.
primary today, I would vote for: Joe Biden
AncientGeezer
(2,146 posts)...suffering from Dementia without an exam? That's cool?
Let's say 1 declared Sen. Warren suffered paranoia delusions with no exam? That's cool?
Public figures right?
primary today, I would vote for: Undecided
BlueMississippi
(776 posts)What you are stating does not fit available evidence.
Nothing takes away the responsibility of the Sanders campaign from giving a full disclosure. People have a right to know.
primary today, I would vote for: Joe Biden
pnwmom
(108,959 posts)there are only 2 options: either a heart attack or unstable angina -- which can be just as serious as a heart attack and which sometimes prevents a doctor from using stents for fear of provoking a heart attack.
So either way, the "event" seems to be more serious than Bernie's team is letting on.
primary today, I would vote for: Joe Biden
Cha
(296,872 posts)primary today, I would vote for: Joe Biden
ms liberty
(8,558 posts)His campaign has no authority to release any of his medical information, and neither do his doctors. Bernie and/or his wife if she is authorized on his insurance, would be the only persons who could make that decision.
If they had trumpeted his troponin levels as you seem to have wanted, most of America would have had to google troponin to find out what it was, and then they would have shrugged and moved on, with little understanding of what it actually meant. Most people don't care about that level of detail, and they don't need to know anyway.
primary today, I would vote for: Joe Biden
primary today, I would vote for: Joe Biden
Baclava
(12,047 posts)I can't imagine a brutal, stressful coast to coast primary campaign trail would be the prudent path forward.
If it was me I'd be looking at those vacation cabins I own as a far better alternative to life on the road.
primary today, I would vote for: Joe Biden
NurseJackie
(42,862 posts)Based on current estimates, he'll be out of the HOSPITAL and headed back home to Vermont by Sunday. That'll be SIX DAYS in the HOSPITAL. Then he's going to continue resting at home? Well that's EXCELLENT ADVICE, and I hope he takes it.
I think people need to look at the big picture to get a better appreciation for what's going on.
It may be "routine" and "common" ... but it's also invasive and dangerous, and it's not something that's taken lightly. Bernie has heart disease (obviously) and this procedure was undertaken to save his life. It's not a pre-emptive treatment like a shingles shot or a flu shot. It's invasive and serious.
primary today, I would vote for: Joe Biden
crazytown
(7,277 posts)you know, like necrosis. I went back reading through threads after the official announcement, found that you were right on point.
primary today, I would vote for: Undecided
Croney
(4,657 posts)Karma, step up!
primary today, I would vote for: Joe Biden
ritapria
(1,812 posts)Some people say it's a routine procedure .Others clam Bernie's had a heart attack and should drop out The campaign should get the truth out as soon as possible ...He's been released from the hospital and I wish him well ...Health before Presidential campaigns is the way to go....
primary today, I would vote for: Undecided
Mike Nelson
(9,944 posts)... the Dick Cheney heart attack, which wasn't before it was... I prefer to think Bernie is more honest than Cheney.
primary today, I would vote for: Joe Biden
peggysue2
(10,823 posts)Certainly at the very least Bernie Sanders had a 'coronary event' that required a double stent procedure to alleviate an arterial blockage. The good news is he got to the hospital in time. The bad news is this will take a toll on his campaign. All depends on whether he can resume campaigning although his campaign had pretty much run out of gas anyway.
Will he retreat, drop out? I really doubt it unless the campaign staff is playing loosey-goosey with the medical facts. I fully expect the man to come back--maybe on a reduced-event schedule--and keep pumping the airways with his promises of free-everything for the American public. It's the nature of the man, someone we've watched and heard over many years. His persistent/stubborn personality will push things to the max.
IMHO unless the medical advice is grim and grimmer, I think we'll see Sanders back on the trail, doing what he does.
primary today, I would vote for: Joe Biden
sdfernando
(4,927 posts)He was lucky and had a non-stemi. There was no damage to the heart muscle. It was stented and he is fine. Over the ensuing years he has had 3 more stents placed, but these were cautionary as there was no new heart attack, but there were plaques the could cause issues so he opted to have the stents placed....that was 6 years ago and he is doing fine, working out and riding his bike, and singing (really loudly).
So long as they get the plaques taken care of Bernie should be fine. Follow his Drs. orders and take the meds he is supposed to to prevent new lesions in the arteries.
primary today, I would vote for: Joe Biden
MFM008
(19,803 posts)May have showed closing arteries that was causing chest discomfort without an actual heart attack.
When my dad had his heart attack in 1982 all his pain was in his back. He thought he had pulled a muscle or had the flu.
primary today, I would vote for: Joe Biden
AncientGeezer
(2,146 posts)This Dr. hasn't examined the Senator......I don't see where he's seen Sanders test results he admits so.....it's unethical to do this.
I'm not a fan of the Senator....too many promises that can't be payed for....what this "Dr." opines....and admits...."Without a close look at Sanders medical chart, its impossible to make a definitive diagnosis, and I have not reviewed the details of his case other than what has been reported to the media by his campaign.."
makes any diagnosis a hit piece.
primary today, I would vote for: Undecided
NurseJackie
(42,862 posts)It's obvious that this type of "diagnosis" is going to happen in the absence of "official" information that's thorough, honest and complete. I guess someone in the BS campaign decided that it was "better" to be secretive and cagey and let the rumors and speculation grow.
If that's the case, then I can only presume that the REAL news has a good chance of being WORSE than all the speculation that we're hearing now.
primary today, I would vote for: Joe Biden
pnwmom
(108,959 posts)to quote from the WSJ:
primary today, I would vote for: Joe Biden
NurseJackie
(42,862 posts)... which leads me to believe that someone on the campaign is trying to hide something. Or someone is just trying to finesse the shit out of bad news and try to turn it into something positive.
In any case, one thing is certain... this is almost certainly the end of the BS campaign. in the end, BS may live to be a hundred... but voters may not have confidence in him because of this.
Either he's going to voluntarily withdraw for the sake of his own health, OR... the voters will feel so uncomfortable supporting a candidate that they (the voters) fear may not make it to inauguration day... and they'll just politely move on to someone else in whom they have more confidence in their ability to be a vigorous campaigner and strong and forceful POTUS.
primary today, I would vote for: Joe Biden
RhodeIslandOne
(5,042 posts)He was 82 or so.
His heart attack was mild (he thought he was coming down with pneumonia) but it lasted long enough before he went to the ER that it caused some damage. The blockage formed from diabetes causing particles of cholesterol to loosen and form the dam blocking flow to his heart. They put the stent in and an hour later he was resting comfortably. He seems ok now.
Another guy I knew casually told me he had double bypass surgery over the summer. I thought they rushed you in for that but he was like no, they scheduled it and a few days later did the operation. I always assumed that was an emergency.
primary today, I would vote for: Joe Biden
pnwmom
(108,959 posts)Last edited Fri Oct 4, 2019, 03:02 AM - Edit history (1)
And the other concerning part of the story:
That leaves unstable angina as the only alternative to a heart attack. Unstable angina is an increasingly controversial topic among experts. In essence, unstable angina is progressive coronary artery narrowing that causes worsening symptoms, but is not necessarily accompanied by new EKG findings or abnormal blood tests. Its basically an impending heart attack, a ticking time bomb, in which the cardiac muscle has not yet diedbut could crumple at any minute. Patients can have unstable angina for minutes, days, weeks, or even longer. While patients with unstable angina who receive stents often feel better afterward and heart attacks are prevented in a small number of them, the risks of the procedure are considered so dangerousincluding bleeding, and even the possibility of inducing a heart attackthat only patients with severe risks and/or severe symptoms should undergo cardiac catheterization.
Its also true that some patients bounce back quickly and essentially return to normal.So, again, taken together, the facts we know are that Sanders required two stents and that this occurred in an acute clinical scenario. This means that either it was a heart attack or that it was unstable angina. Unstable angina carries just as poor a prognosis as many, though not all, heart attacks.
primary today, I would vote for: Joe Biden
Optical.Catalyst
(1,355 posts)primary today, I would vote for: Undecided
RandySF
(58,511 posts)primary today, I would vote for: Joe Biden
Optical.Catalyst
(1,355 posts)primary today, I would vote for: Undecided
RandySF
(58,511 posts)Simmer down.
primary today, I would vote for: Joe Biden
We rushed my mother to her doctor because she had the same symptoms as Bernie. They kept her waiting because they didn't believe her. Finally hooked her up to a machine and the nurse came out to say, OMG, it's a heart attack. No surgery. A mild one.
Emergency fixing things of the heart: heart attack. Lots of people have them. Bernie should think of his health first. His supporters should think of his health first, too. No reason why he has to run for president. The next president will be cleaning up the mess the Republicans made, just like President Obama had to do.
primary today, I would vote for: Joe Biden
primary today, I would vote for: Joe Biden
SidDithers
(44,228 posts)After two and a half days in the hospital, I feel great, and after taking a short time off, I look forward to getting back to work, Mr. Sanders said in a statement.
https://www.nytimes.com/2019/10/04/us/politics/bernie-sanders-hospital.html
Sid
primary today, I would vote for: Undecided
tishaLA
(14,176 posts)Best wishes to the junior senator from VT
primary today, I would vote for: Undecided