Details on Cheney’s Illness Are Few

Vice President Dick Cheney spent 4 1/2 hours in a hospital early Monday, but White House officials offered only limited details about what led him to seek treatment.

Officials said Cheney, who is 64 and has suffered four heart attacks, experienced shortness of breath as a reaction to anti-inflammatory drugs to treat a “preexisting foot condition.” He was taken to George Washington University Hospital in downtown Washington at 3 a.m. EST.

The officials said doctors noticed that Cheney was “retaining fluid” as a response to the medication. He was released about 7:30 a.m. after doctors prescribed diuretics to eliminate the fluid.

The vice president returned to work in the afternoon, and aides said he was feeling fine. But the incident sparked renewed questions about the health and fitness of the man who is first in line to succeed President Bush and, as the behind-the-scenes architect of Bush’s foreign policy, has emerged as one of the most powerful vice presidents in history.

While White House officials have routinely offered details of Bush’s medical checkups and even of Cheney’s heart difficulties, an air of mystery hovered over Monday’s events.

White House Press Secretary Scott McClellan repeatedly refused to reveal the details of the foot condition that had prompted Cheney to walk with a cane during public appearances last week. The vice president had even joked that the mystery over his foot problem was “driving the press nuts.”

A spokeswoman for the vice president could offer only speculation, saying Monday that doctors had not conclusively diagnosed the problem.

“He has occasional bouts with inflammation in his left foot, sometimes in the heel, which has been diagnosed as tendinitis, sometimes in the joint of his big toe, which has not been definitively diagnosed,” spokeswoman Lea Anne McBride wrote in an e-mail. “Some doctors have suggested it might be gout, but he does not suffer from the acute pain usually associated with gout, nor does he have raised levels of uric acid in his blood, which is also associated with gout. Other doctors have suggested that osteoarthritis is the cause.”

Gout is a form of arthritis that most often strikes the large joint of the big toe, but also can occur in the feet, ankles, knees, hands and wrists.

Officials declined to offer further details, such as which anti-inflammatory medication led to Cheney’s reaction.

An administration official said Cheney was not diabetic, a condition often associated with foot problems. Officials said the foot condition was not related to surgery he had in September to treat aneurysms in both knees.

The last time Cheney publicly complained of foot pain -- during a fundraising swing in the 2002 congressional campaign cycle -- aides blamed the problem on a bone spur resulting from an injury to his Achilles tendon.

On Friday, Cheney used a cane to walk, sat on stools to deliver two speeches and rode in a motorized cart while touring a Harley-Davidson plant in Kansas City, Mo. He poked fun at himself -- and at the public’s interest in his health -- along the way.

Reporters “keep asking my staff: What happened to the vice president; is it serious?” Cheney told troops at Ft. Leavenworth, Kan. “And so I said, ‘No, [Defense] Secretary [Donald H.] Rumsfeld bit me in the ankle.’ ”

White House officials said Bush first learned of Cheney’s hospital visit from Bush’s own doctor, and then the president and vice president spoke by telephone shortly after Cheney left the hospital.

McClellan waved off repeated questions Monday about exactly what was ailing Cheney. But he disputed assertions by some reporters that the White House was being secretive.

“The vice president’s office takes the appropriate steps to provide information to the public about his health, and his doctors do, as well, through the vice president’s office,” McClellan said.

Cheney’s health has been closely watched since he suffered his fourth heart attack shortly after the 2000 election that put him and Bush in power. Doctors implanted a defibrillator in his chest in 2001 to ensure a regular heartbeat.

Experts who were not familiar with the details of Cheney’s condition speculated Monday that the incident was minor.

“That he was treated promptly and released from the hospital quickly is a clear sign that this is not a serious incident,” said Dr. Robert Frankel, associate director of interventional cardiology at Maimonides Medical Center in New York City. “There is no indication that Cheney has developed any new heart condition, or that his existing heart conditions are worsening in any way.”

Still, Dr. Richard Lubman, a lung specialist at Keck School of Medicine of USC, cautioned that the over-the-counter drugs most often cause fluid retention in the feet and legs, and only very rarely in the lungs. “Given his history,” he said, “we have to wonder if it isn’t due to some heart problem.”

Gout is an occasional side effect of the drugs that are used to reduce high blood pressure, and it is commonly treated with over-the-counter anti-inflammatory drugs such as ibuprofen and naproxen.

Those drugs can occasionally reduce blood flow in the kidneys, leading to a buildup of fluid in the lungs that makes breathing difficult. Administration of diuretics helps remove the fluid, restoring breathing quickly.

The other potential causes of Cheney’s foot condition mentioned by his office -- tendinitis and osteoarthritis -- could both be related to his being overweight. Both of those conditions would also be treated with anti-inflammatory drugs.

With his decision to joke about his condition last week, Cheney followed the lead of Bush, who poked fun at himself a few days earlier when he appeared in public with a 2-inch scratch above his left eye.

“As you can possibly see, I have an injury myself -- not here at the hospital, but in combat with a cedar,” Bush said Jan. 2 as he visited Brooke Army Medical Center in San Antonio to meet with injured soldiers. He was apparently referring to an injury he sustained while clearing brush on his Texas vacation property.

“I eventually won,” Bush said. “The cedar gave me a little scratch.”

Wallsten reported from Washington and Maugh from Los Angeles.

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Medical history

A summary of Vice President Dick Cheney’s health problems:

1978: Cheney suffers his first heart attack, at age 37.

1984: He has a second heart attack.

1988: After suffering his third heart attack, Cheney has quadruple bypass surgery to clear clogged arteries.

2000: Cheney suffers what doctors call a “very slight” heart attack, his fourth, and undergoes an angioplasty to open a clogged artery. (After the 2000 heart attack, Cheney begins a daily 30-minute regimen on a treadmill and begins eating healthier. He takes medication to lower his cholesterol. He quit smoking in 1978.)

March 5, 2001: A little more than 100 days later, Cheney feels chest pains and undergoes another angioplasty to reopen the same artery.

June 30, 2001: The vice president returns to the hospital and has a special pacemaker called an implantable cardioverter defibrillator, or ICD, inserted into his chest. During his 2004 annual checkup, doctors say the device has never automatically activated to regulate, which they say means Cheney’s heart is functioning normally.

Nov. 13, 2004: Cheney enters the hospital after complaining of shortness of breath. He leaves after three hours. An aide says tests found no abnormalities.

Sept. 24, 2005: The vice president undergoes surgery to repair an arterial aneurysm on the back of each knee.

Monday: Cheney is taken to a Washington hospital after experiencing shortness of breath attributed to fluid retention resulting from medication he was taking for a foot problem. He is placed on diuretics and released.

Source: Associated Press