The medical problem Sanders experienced — though it can be serious if untreated — is a common affliction in men his age. And the procedure he underwent is one of the most routine performed by cardiologists.
“This is a common procedure. It’s very safe. People recover quickly,” said Steven Nissen, chair of cardiovascular medicine at Cleveland Clinic. “I’ve treated businessmen who go back to work the next day. I’ve had patients in the U.S. Senate who have gotten right back to work. Although, if Bernie were my patient, I might tell him not to work 16 hours a day for a little while, just to make sure recovery goes well.”
Coronary arteries — arteries that feed blood to the heart muscle — can become blocked over time with the buildup of fatty deposits or plaque. As the artery narrows, it reduces blood flow and can cause chest pains. Heart attacks happen when that blood flow to a part of the heart becomes completely blocked.
So when a patient like Sanders comes in complaining of chest pains, doctors usually perform an angiogram to diagnose the problem, said Elizabeth Klodas, a cardiologist in Minneapolis. That means inserting a small catheter — about the thickness of a cooked piece of spaghetti — into an artery in the patient’s wrist or groin. That catheter goes up to the heart area, where it can inject dye into the coronary arteries, allowing doctors to see them through x-ray.
“That gives you a road map and shows you where the blockages may be,” Klodas said. Once doctors identify where the problem is, they can maneuver a balloon-tipped tube to the site of the blockage. The balloon is inflated, opening the artery back up so blood can fully flow again. The stent is a “tiny wire mesh tube,” according to the American Heart Association — “kind of like chicken wire,” Klodas notes — that expands with the balloon but stays in place permanently after the balloon is deflated and the catheter is withdrawn. The stent is what keeps the artery propped open, so blood can flow to the heart muscle for years to come.
The fact that doctors placed two stents in Sanders could mean he had two blockages on the same artery, or that it was an especially long blockage that required two stents to open up, Klodas said.
“It’s an in-and-out procedure and can take as little as 30 minutes,” said Allen Taylor, chair of cardiology at MedStar Heart & Vascular Institute. “And the outlook is often very good.”
At 78, Sanders is the oldest among the candidates running for the Democratic nomination. Sanders’s doctor released a letter during the 2016 campaign showing he had a history of elevated cholesterol but no indication of heart disease at the time.
Heart disease is the leading cause of death for men in America, resulting in 1 in 4 male deaths. In some ways, Sanders was fortunate, experts note, because half the men who suddenly die of heart disease have no previous symptoms, such as the chest pains Sanders felt.
Sanders often jokes about his age at town halls and when meeting with voters. But age is one of most dominant factors in heart disease — along with other factors including family history, cholesterol level, blood pressure, obesity and diet. And Sanders’s heart problem may revive the topic of age among Democratic Party voters, who must choose in coming months whether to nominate a candidate from among the three candidates over the age of 70 or from the new younger generation of leaders also running.
Many U.S. leaders have had heart problems. After leaving office at age 58, former president Bill Clinton had quadruple bypass surgery in 2004 because of extensive blockages in his arteries. Former president George W. Bush had a stent placed in his artery in 2013. Former vice president Richard B. Cheney suffered five heart attacks beginning at the age of 37. He required several procedures while in office and had a heart transplant after leaving office in 2012.