ick Cheney's 1988 heart bypass was done with an artery from his chest rather than a vein from his leg, the new candidate said yesterday. Doctors consider the artery method to be more effective.
Cheney, George W. Bush's vice presidential selection, suffered his first heart attack at 37, while running for Congress in 1978.
After suffering two more heart attacks, Cheney had quadruple bypass surgery in 1988. That history has some worried about him possibly standing in for the president.
Cheney's doctors have given him a clean bill of health and have said he is on cholesterol-lowering medications. Boston cardiologists say that more information about his cholesterol and stress-test results is needed to make an independent, definitive judgment about his fitness for office.
Heart attacks often result from fat and cholesterol blocking the arteries that carry blood to the heart muscle. In a bypass operation, doctors use an artery or vein from the patient's body to construct a detour around the blocked part of the artery.
Cheney had a quadruple bypass, meaning four detours were made.
Deeb Salem, chairman of medicine at New England Medical Center and former president of the American Heart Association's New England affiliate, said that 12 years later, the key questions are ''plumbing issues:'' Has the bypass developed a blockage, or have new blockages developed in other areas?
Bypasses done with arteries are generally considered more beneficial and more likely to last, according to the American Heart Association.
Salem said there are three other indicators of potential problems:
Does Cheney have symptoms such as chest pains?
How strong is his heart? Normally, the heart squeezes 50 percent of the blood in it with each beat. Heart attacks can damage the muscle and decrease that percentage.
How did he do on his last stress test? In this procedure, a radioactive substance is injected into the blood and tracked while the patient runs on a treadmill to see if enough blood flows to the heart.
''If he flunked all three of those, I'd say the chance of him having a bad event in the next four years is pretty high,'' Deeb said. But if all three indicators look good, he said, those chances are dramatically reduced.
As for the stress of the job, it's relative. Salem said intense jobs are not inherently a health risk, especially for those who thrive on pressure.
The vice presidency - sometimes the butt of jokes for its often ceremonial role - is hardly more stressful than the other jobs Cheney has held since his surgery. He was secretary of defense in the Persian Gulf War, and he is now chief executive officer of Halliburton Corp., an energy company based in Dallas.
This year an estimated 1,100,000 Americans will have a new or recurrent coronary attack, and more than 40 percent will die as a result, according to the American Heart Association. On the other hand, with increasingly effective preventive measures, people have a better chance of a long life if they survive.
Other health issues in Cheney's past have included the removal of a skin cancer, said Bush communications director Karen Hughes.
And, she added, he is allergic to pomegranates.
Anne E. Kornblut of the Globe Staff contributed from Austin, Texas.
