Heart Ailment Puts Yeltsin Back in Hospital

President Boris N. Yeltsin was taken by helicopter to a Moscow hospital with a heart ailment Thursday, only two days after returning from a New York summit with President Clinton that aides blamed for straining the Russian leader’s health.

The sudden aggravation of a heart condition that has plagued Yeltsin for nearly a decade prompted the Kremlin to cancel a state visit to China in two weeks and threw into doubt Tuesday’s scheduled gathering of Balkan leaders in Moscow.

“The condition of the president does not give much ground for optimism. He will hardly be able to return to work within a couple of days,” chief presidential aide Viktor V. Ilyushin told journalists at a rare Kremlin briefing on Yeltsin’s health.

The attack of myocardial ischemia, which disrupts blood supply to the heart muscle, struck while the 64-year-old president was resting at a dacha in the resort community of Zavidovo, a two-hour drive north of Moscow. He was flown to Moscow’s Central Clinical Hospital in the early afternoon after reporting that he felt ill, Ilyushin said.

It was the second time in less than four months that Yeltsin had to be hospitalized with the condition. He suffered a mild heart attack July 11 and spent the next month recuperating.

Ilyushin blamed Yeltsin’s ambitious autumn travel schedule for his current affliction. “The illness is the result of the heavy workload connected with his short visits to Paris and New York, the tension of the talks and the tension of expectations,” the adviser said.

Yeltsin flew to France for a one-day meeting with French President Jacques Chirac last Friday, a day after appearing weary at a Kremlin interview with U.S. and Russian journalists. He then traveled to the United Nations for celebrations of the world body’s 50th anniversary and a high-profile meeting with Clinton in Hyde Park, N.Y.

Yeltsin had made no public appearances since his return to Moscow on Tuesday, and the sudden announcement that he was again in the hospital stirred concern among Western diplomats and Kremlinologists. Many analysts fear Russia’s post-Communist political structure may not be mature enough to survive its first succession struggle should the president’s health worsen.

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Russia’s constitution designates the prime minister to fulfill presidential functions in the event of the leader’s death or incapacitation. The current head of government, Viktor S. Chernomyrdin, drew high praise for his handling of a hostage crisis in June, when Yeltsin was in Canada for a summit of the Group of Seven industrial powers. But Yeltsin’s security entourage of former KGB officials wields considerable influence with the president and could be resistant to a transfer of power to the more conservative Chernomyrdin.

Ilyushin said decisions about the president’s travel schedule and whether he will continue to carry out official duties will be made only after further medical tests.

“We are worried about this. Many of the plans will not be realized,” Ilyushin said of Yeltsin’s itinerary, which was to have included an important conference of Balkan leaders at the Kremlin on Tuesday and taken him to Siberia, China and Norway next month.

The Interfax news agency quoted unnamed officials close to Yeltsin as saying the president was “extraordinarily tired” after his return from New York.

The hesitant assessments by Yeltsin aides contrasted sharply with the immediate attempts to play down the seriousness of his last ailment, prompting speculation that he has suffered a more severe attack this time.

However, Igor Ignatiyev, head of the presidential press service, described Yeltsin’s heart trouble as “lighter than in July.”

“I would not consider his condition as life-threatening,” Ignatiyev said, adding that “the president is in charge.”

The recurring heart trouble coupled with occasional incidents of strange behavior have cast doubt on Yeltsin’s ability to win or even wage a reelection campaign next year.

Yeltsin dropped out of sight for two weeks in December, when the Kremlin attacked the breakaway republic of Chechnya. Two months earlier, he had needed assistance walking during a meeting of former Soviet republic leaders in Kazakhstan. And Yeltsin failed to get off his plane for a meeting scheduled with the Irish prime minister during a stopover in Shannon in September, 1994.