Coronary artery bypass: The news that Bill Clinton had a bypass last week surprised me as he always looks so fit. Why did he need this operation?
The coronary arteries supply blood to the muscle of the heart. If these arteries become narrowed by deposits, the amount of blood supplied to the muscle becomes markedly decreased. When the person exercises or exerts themselves, the heart requires more blood, but with a narrowing of the arteries and the subsequent reduction in blood supply, the muscles of the heart cramp causing angina.
Many people with this problem can control the symptoms with medications such as nitrates and beta-blockers. In some people, however, the condition can be resistant to drug therapy and an operation is required.
Sometimes an artery can become completely blocked, possibly by a clot, resulting in the heart muscle receiving no blood supply, and it can die.
This is called a myocardial infarction or heart attack. When the arteries are severely blocked, it is necessary to bypass the blocked arteries to reduce the risk of heart attack.
What do they bypass the blockage with?
Usually a vein is removed from the patient's leg and used as a bypass graft. By using sections of the vein, it is possible to attach one end to the coronary artery beyond the blockage while the other end is attached to the healthy artery before the blocked area. This allows a good blood supply to be returned to the heart, preventing further attacks of angina and reducing the risk of subsequent heart attack.
He had a quadruple bypass, while a friend of mine had a triple one. What's the difference?
Quadruple and triple refers to the number of arteries bypassed. In a quadruple bypass, four arteries are bypassed, while in your friend's case, only three of the arteries required the procedure.
Bill Clinton smoked cigars. Did this contribute to his problems?
Well, Bill's fondness for cigars certainly affected his political career but would also have contributed to his need for cardiac surgery, as would his fondness for fast food. Smoking causes hardening of the arteries which causes angina and coronary attacks. If he hasn't given them up already, now would be a good time to kick the habit!