Aspin to Get Pacemaker Today as Heart Condition Slips

Defense Secretary Les Aspin’s physicians said Wednesday that the coughing spells he suffered before being hospitalized late Tuesday were caused by a worsening heart problem and they said that they plan to implant a pacemaker today to prevent further deterioration.

At a press conference, Aspin’s doctors said that a new evaluation showed his condition has now reached the point where even minor difficulties “can make him sick enough to wind up in the hospital.” Earlier, they had thought that his symptoms might have been from recurring bronchitis.

But the physicians--two cardiologists and an internist--insisted that the pacemaker is likely to relieve the unwanted symptoms and strengthen his heart and they said that they expect him back on the job next week.

President Clinton, asked whether he might have to replace Aspin as a result of the secretary’s ailments, brushed off the suggestion as premature. “People get pacemakers all the time,” the President told a news conference. “As far as I know, he’s doing just fine.”

Nevertheless, the report is expected to intensify concerns about whether the 54-year-old former Wisconsin congressman, first diagnosed as having heart trouble two years ago, will be able to keep up the pace his job requires.

Aspin, known as a workaholic, has an especially full plate as defense secretary, including a major review of the nation’s defense strategy, overseeing reductions in the size of the military and dealing with crises in Bosnia and other global trouble spots.

Although the physicians insisted that Aspin’s illness is not life-threatening, they conceded that they cannot rule out the possibility his condition will worsen. They said that such situations vary widely among individuals.

The latest bout marked the second time in three weeks that Aspin has been hospitalized for heart problems. On Feb. 21, he underwent 3 1/2 days of tests after suffering a toxic reaction to a typhoid vaccination, exacerbated by a bronchial infection.

Physicians said then that the defense secretary had experienced a mild worsening of the 1991 heart condition and suggested that he have a pacemaker implanted. Until his second bout on Tuesday, he had planned to have the procedure done in early April.

Aspin has hypertrophic cardiomyopathy, a congenital ailment in which the heart muscle is enlarged until it restricts the amount of blood pumped from the heart. He also suffers from mild coronary artery disease.

The pacemaker, a so-called “dual-chamber” device, is designed to make the heart beat less vigorously rather than to regulate the rate of the beat. Although pacemakers have been in use for years, the use of the device for this purpose is relatively new.

Aspin has decided not to relinquish authority as secretary during his hospital stay and will remain fully conscious during this morning’s two-hour-long pacemaker-implant operation, which physicians said would be done using a local anesthetic.

The secretary has had a secure telephone line installed in his hospital room. He received staff aides and conferred with other officials throughout the day Wednesday. His physicians described him as “cheerful” and “optimistic.”

The physicians said that they do not expect to have to consider the next option in the process--open-heart surgery known as a myotomy-myectomy, and, eventually, a possible heart transplant. But they said that they will monitor Aspin’s progress closely.

At the same time, they stressed that Aspin’s symptoms are relatively mild and that he is not in a high-risk category. But they said that the pacemaker is needed because his condition makes him “vulnerable to having episodes.”