Bill Clinton Hospitalized for Chest Pain

Former President Bill Clinton, 63, was admitted to a New York hospital today. He was seen by his cardiologist for chest pains, and was admitted. He underwent a procedure where stents were place in a coronary artery. An official statement from his spokesperson, Douglas Band, said:

“Today President Bill Clinton was admitted to the Columbia Campus of New York Presbyterian Hospital after feeling discomfort in his chest. Following a visit to his cardiologist, he underwent a procedure to place two stents in one of his coronary arteries. President Clinton is in good spirits, and will continue to focus on the work of his Foundation and Haiti’s relief and long-term recovery efforts.”

Readers may recall that Clinton underwent quadruple bypass surgery in 2004 at Columbia Presbyterian Hospital. Doctors had found that some of these arteries had more than a 90 percent blockage.

Coronary artery disease (CAD) is the most common kind of heart disease. It is the leading cause of death in the United States. It occurs when the blood vessels that supply blood to the heart muscle itself (the coronary arteries) become narrowed by a build up of plaque. Plaque is made up of cholesterol, fat, calcium and other substances from the blood. With narrowing of the arteries comes a decrease in blood supply to the heart muscle. This can lead to the symptoms of chest pain (angina) or even heart attack if the narrowing is severe enough, or if part of the plaque breaks off and blocks a smaller part of the artery.

11.10.Rea1Source: NLHBI

Unlike coronary artery bypass, where the chest is opened and surgeons bypass obstructed arteries with blood vessels taken from elsewhere in the body, angioplasty (with or without stent placement) is done “percutaneously”. This means that a catheter is inserted into the large artery in the groin, and is threaded up into the coronary arteries. The catheter has a small balloon on its tip. The balloon is inflated at the blockage site in the artery to flatten the plaque against the artery wall. Angioplasty is also called percutaneous transluminal coronary angioplasty (PTCA).
After treatment, the guide wire, catheter, and balloon are removed. The hospital stay and recovery time for angioplasty is shorter than that of bypass. But about 35% of patients are at risk for more blockages in the treated area. This is called restenosis which usually happens within 6 months after angioplasty.
Source: Texas Heart Institute

A stent procedure is used along with balloon angioplasty. It involves placing a mesh-like metal device into an artery at a site narrowed by plaque. The stent is mounted onto the balloon-tipped catheter, threaded through an artery, and positioned at the blockage. When the balloon is  inflated, stent is opened. Then, the catheter and deflated balloon are removed, leaving the stent in place. The opened stent keeps the vessel open and stops the artery from collapsing. Restenosis rates with this procedure are generally around 15% to 20%.

Because restenosis is a problem with the stent procedure, doctors have been trying to find ways to keep arteries with stents open. Some newer stents are covered with medicines that help keep the artery from closing up again. These are called coated stents or drug-eluting stents.

For more information:

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Coronary Angiography
Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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