Aspin Fit to Do a Full Job Load, Physicians Say : Defense: They agree secretary’s heart condition would not be aggravated by long work days and stress of high office.

As colleagues in the Pentagon and Congress wonder about the implications of Defense Secretary Les Aspin’s health problems, medical experts said Friday that his ailment should not prevent him from shouldering his huge workload and will only curtail his participation in certain sports activities.

While the condition, hypertrophic cardiomyopathy, can be life threatening in rare instances, it only becomes dangerous when individuals engage in “extreme strenuous and competitive physical exertion,” said Dr. George Bren, a cardiologist and associate clinical professor at George Washington University, adding: “Job stress is probably not very important in all of this.”

The condition is a thickening of the heart muscle that makes it more difficult for the heart to pump blood away from itself to the rest of the body. This can cause the blood to back up, causing such symptoms as the shortness of breath Aspin experienced Sunday.

“The heart has a difficult time relaxing and filling up with blood, just as it’s hard to stretch out a thick rubber band compared to a thin rubber band,” Bren said.

On Thursday, Dr. David Pearle, a Georgetown University Medical Center cardiologist and the 54-year-old Aspin’s primary heart doctor, said he and others have recommended that Aspin get a permanent pacemaker. The procedure, performed using local anesthesia, would implant the device under the collarbone with a wire leading to the bottom of the heart.

In this instance, the pacemaker would reverse the contraction “wave” of the heart, and, as a result, ease the obstruction caused by the backup of blood, experts said. Usually, pacemakers are used to regulate the speed of the heart rate, but in this case it would instead alter the contraction pattern of the heart muscle, they said.

Aspin’s heart condition was discovered two years ago when he experienced shortness of breath while skiing in Colorado. He again experienced shortness of breath Sunday and was then hospitalized, but Pearle said the effect on his heart was caused by two other conditions, a mild and persistent arthritis, and a reaction to a typhoid inoculation he received two days before.

Aspin will be at risk only if he plays vigorous, competitive sports, the doctors said. Such activity could result in sudden death from an irregular heart rhythm, they said.

“I read he was a squash player,” said Dr. Douglas Zipes, a cardiologist and professor at Indiana University School of Medicine. “From now on, that’s going to be a no-no.”

Aspin’s doctors have already recommended that he give up squash and take up swimming, walking or cycling.

“This is a condition that has some, but a very small, potential to cause death,” Bren said. “He should avoid very vigorous, competitive-type athletics. It should not prevent him from being active otherwise, and should not prevent him from performing all the duties in his post, including working very hard, and putting in long days.”

Aspin’s heart ailment can also be treated with a drug, amiodarone, but experts said this medication can have serious side effects, including damaging thyroid function, and is not typically the first treatment of choice.

“If the situation could be corrected with a drug that is easily taken, you would go to the drug,” said Dr. George Sopko, a medical officer/cardiology expert at the National Heart, Lung and Blood Institute. “But you don’t use this drug as a first line or even second line therapy. It is a drug of last resort.”