KPCC Reveals President Bush Has A Heart Arrhythmia

White House Did Not Disclose After Pretzel Incident That Mr. Bush Has Sinus Bradycardia

© 2002 David Robb

President Bush has a heart arrhythmia called sinus bradycardia that makes him more prone to fainting when he gags or chokes. It's why he passed out January 13 in the highly publicized pretzel incident.

Bradycardia means that the president's heart beats more slowly than the average person's heart. It gets its name from the Latin brady=slow + cardia=heart. 'Sinus' refers to the sinus node, which is the heart's natural pacemaker.

The press has reported that Bush has a slow heart rate. In August, after President Bush underwent a physical exam, the White House reported that his resting heart rate was 43 beats per minute. On Jan. 14, the day after the president's fainting episode, the Los Angeles Times reported that Bush has "a resting pulse rate of 35 to 45 beats per minute, which medical personnel consider extremely low even for a well-trained athlete." White House spokesman Ari Fleischer told reporters the day after Bush's fainting spell that the president's resting heart rate was 51 beats per minute.

But up until now, the White House has not volunteered, and the media has not reported, that the president's slow heart rate is due to a heart arrhythmia called sinus bradycardia. But now the White House is confirming this.

Several calls to White House physician Dr. Richard Tubb finally got this response: "The president has sinus bradycardia consistent with athletic conditioning," he said through White House spokesman Ken Lisaius. "The president's resting heart rate is 38 to 49 beats per minute."

"That's the very definition of bradycardia," said Dr. Harold Karpman, a heart specialist at Cedars-Sinai Medical Center in Los Angeles and a clinical professor at UCLA. Indeed, any heart rate slower than 60 beats per minutes is, by definition, bradycardia.

Generally speaking, a slow heart rate is a sign of a healthy heart, and many well-conditioned athletes have resting heart rates well below the normal 60-80 beats per minute. Bush, who works out for an hour every day and who regularly runs three miles in under 21 minutes, has the resting heart rate of a well-conditioned athlete, according to Dr. Tubb.

But one common problem associated with bradycardia is fainting.

Bush fainted while watching a football game in the White House on Jan. 13 after gagging on a pretzel. He fell to the floor, bruising his left cheek and his lower lip. In a recent interview with NBC's Tom Brokaw, Bush said that after he regained consciousness, he called his wife, who was upstairs in the White House residence, and said: "Come down. Something terrible's happened." The day after the incident, Bush joked with reporters: "My mother always said, 'When you're eating pretzels, chew before you swallow.'"

"Anytime you have bradycardia, the most serious concern is fainting spells," said Dr. Suneet Mittal, a heart specialist at New York Hospital, Cornell University Medical Center.

Fainting can be triggered in people with slow heart rates when their hearts - for whatever reason - slow down even more. This can happen when the vagus nerve -- the nerve that goes from the brain to the heart to the stomach -- is stimulated by choking or gagging.

"Anytime you have gagging, you can further activate the vagus nerve, and that will cause your heart rate and blood pressure to drop further," Dr. Mittal said. "From what I read in the newspapers, he may not have been feeling well, and that may have decreased his heart rate. And if you add the gagging on top of that, it could decrease the heart rate even further, and you have a fainting spell."

Dr. Karpman said that the president's fainting spell "seems to be a pretty innocent and common thing. The reflex that is initiated by coughing or by gagging initiates the reflex that causes the heart rate to drop, and depending on where your heart rate started that day, it could cause you to faint. It would be a consequence of this reflex, which is known as the vasovagal reflex."

Dr. Tubb described this very same sequence of events in an interview with reporters shortly after the president fainted. On the day after Bush's fainting spell, the Los Angeles Times reported: "Tubb said that Bush's slower heart rate made him more prone to fainting when a nerve was stimulated by the pretzel caught in his throat. The medical term for such an episode is vasovagal syncope, or vasovagal fainting, Tubb said. In such cases, the body sends a signal to the heart via the vagus nerve. This causes a sudden drop in heart rate, which is restored when the person falls."

But neither the Times, nor any other news organization, has yet to report that Bush has a heart arrhythmia called sinus bradycardia.

"He has bradycardia," Dr. Karpman said. "There is no doubt. Anything under 60 (beats per minute) is defined as bradycardia."

"Bradycardia is an arrhythmia - a malfunction of rhythm," said Dr. Karpman, who founded the company that developed the Holter monitor, a widely used heart-testing device. "A lot of people have bradycardia and they get along very well. But when the heart rate starts to get into the 30s, then that is really an area that we have to be concerned about."

Dr. Mark Livingston, a consulting physician at the Yakima Valley Memorial Hospital in Washington State, said: "A choking spell can induce bradycardia and is not an uncommon cause of fainting. Many types of gastrointestinal problems may trigger an exaggerated response from the vagus nerve which slows the cardiac pacemaker, decreasing the heart rate. The heart rate may slow to the point at which the brain no longer receives sufficient blood flow, which results in 'faint.' I would say that if our president has a resting heart rate of 38-49 that he definitely has bradycardia. However, bradycardia can be the result of many things; medications, various forms of heart block, physical fitness, or normal variation."

All the heart specialists interviewed for this story see no cause for concern just because the president has a slow heart rate. But in the wake of the president's fainting spell last week, they all recommend that he undergo a series of heart and stress tests.

The press has explored numerous theories about why the president fainted Invariably, most press accounts suggested that the president passed out because the pretzel had blocked his airway, causing him to faint due to a lack of oxygen going to the lungs and then to the brain. In an interview on CNN, Dr. Henry Heimlich, the creator of the Heimlich Maneuver, opined that the president inadvertently performed the Heimlich Maneuver on himself when he passed out and fell to the floor, dislodging the pretzel that was stuck in his throat.

Had the press known that President Bush has sinus bradycardia, and that fainting is a common symptom of bradycardia, the story might have been reported much differently. But the press didn't ask the right question, and the White House didn't volunteer the right answer. Instead, the Bush White House focused on the pretzel, and the press swallowed the story whole.

-- (look@what.you did Cherri!), January 28, 2002

Answers

Yes, his heart rate has increased dramatically since the shit hit the fan at Enron. Hopefully he and Dick will have simultaneous fatal heart attacks before we have to listen to any more of their lies.

-- Mr. Clean (get rid of @ toilet bowl. scum), January 28, 2002.

Lieberman

-- not him too (are@they.all?), January 28, 2002.

Who says white folks don't have arrhythmia?

-- (lars@indy.net), January 29, 2002.

To "look@what.you.did.Cherri:"

Shame on you! To blame Cherri for Bush's overly slow heart rate is monstrously unfair, and you know it.

-- Peter Errington (petere7@starpower.net), January 29, 2002.