M. SPENCER GREEN
Hospitals around the country are seeing an epidemic of "Clinton syndrome" as worried, middle-aged men take the former president's heart problems to heart and rush to get their own tickers checked.
Some, like Gary Haden, are scared enough to pay $400 out of their own pockets for a heart scan at a private center that will get them in the same day they call.
"I had not planned to do it, but I had all the symptoms he had, and he was doing all the things I was doing," like eating lots of fast food, the 56-year-old truck driver from Elk Grove, Ill., said of Bill Clinton.
Chest pains a month ago had frightened Haden into quitting his 40-year smoking habit. Clinton's Labor Day quadruple bypass prompted Haden to seek the scan, which revealed only mild blockage in one artery.
He went to one of 10 centers around the country operated by HeartCheck America Inc. Requests for appointments tripled at many of them this past week, especially in Chicago and Washington, said company president Bruce Friedman.
Tuesday "was the busiest day we've had for scheduling new appointments since the death of Daryl Kile. Before that it was John Candy, and before that it was Sergei Grinkov," he said, referring to the sudden cardiac deaths of the St. Louis Cardinals pitcher, actor and Russian Olympic skater.
The "celebrity effect" also boosted emergency room visits.
At St. Luke's-Roosevelt Hospital in New York City, eight or nine people came in with chest pains each day this past week compared with the usual five, said Dr. Patricia Carey, director of emergency medicine.
"I asked the triage nurse, 'What's wrong with this patient who just arrived?' She said, 'Clinton syndrome.'' It's a way of saying it's a middle-aged man with chest pains who's really worried," Carey said.
One was a 45-year-old Manhattan hotel staff manager who said he had had chest pains for a few days. Asked why he had come to the emergency room, he told Carey: "This thing with Clinton ... my wife said, 'You better get checked.'"
He was admitted for further tests.
Though the trend was mostly older men, some women and younger men also sought help.
A 29-year-old man went to the emergency room at St. Joseph's Hospital in St. Paul, Minn., complaining of chest pains and told the staff, "I guess I can't eat junk food like Bill Clinton anymore."
The hospital admitted more of these emergency patients than usual this past week 44 percent compared with 35 percent last year, a spokesperson said.
Doctors, too, seem to be behaving differently. At UMass Memorial Medical Center in central Massachusetts, five cardiac catheterization rooms stayed open extra hours to do angiograms $5,000 tests that are the gold standard for checking arteries for blockages.
"The increase is fueled as much by referring doctors as by patients themselves," said Dr. Mark Furman, director of interventional cardiology at the hospital.
Some doctors sent patients directly for angiograms without doing the usual treadmill stress tests first.
"They're being more aggressive in managing patients than last week," Furman said. "A lot of people are saying maybe the stress test isn't screening well enough," because Clinton reportedly had normal ones despite his severe blockages.
Insurers generally cover angiograms and stress tests in patients whose symptoms warrant them. But many people take matters into their own hands and head for private heart scan centers, which use a different testing method a type of X-ray to look for blockages. Experts disagree on the value of such scans, and many insurers do not cover them, leaving patients to foot the $400 to $500 bill.
The Clinton case has boosted their business.
Edward Heart Hospital in Naperville, Ill., reported doing eight heart scans a day this past week compared with the usual four a day. Calls to its nurse hot line also had doubled, and many people mentioned Clinton, a hospital official said.
HeartCheck America, Friedman's company, said 60 calls for appointments came in on Tuesday to the two Chicago-area centers jointly operated with the University of Illinois. Typically they get 20 calls, he said.
Some are hoping the publicity will lead people to take steps to prevent disease, not just recognize symptoms. Half of Americans have high cholesterol, one of the leading risk factors for heart disease.
Clinton, who was released from the hospital Friday, confessed he had stopped taking the cholesterol-lowering statin drug he had been prescribed when he left office in 2001. Prescription refill data suggests that half of people put on statins go off them within a year.
"When you ask people to take pills for a lab number instead of a symptom, it's always a difficult thing," said Dr. Richard Stein, associate chair of medicine at Beth Israel Medical Center in New York City and a spokesman for the American Heart Association.
Pain, however, is a more powerful motivator than fear of pain, he said.
A national survey, conducted the week before Clinton's problems, found that two-thirds of Americans do not consider cholesterol one of their top three health concerns.
Although 60 percent had had their cholesterol level checked in the previous year, nearly two-thirds did not know what it was, according to the survey done by the makers of Benecol, margarine products that can lower cholesterol.
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