President George W. Bush’s recent brush with PCI offers an opportunity to educate the public about the need—and sometimes not the need—for coronary angioplasty and stents.
Medical procedures performed on prominent politicians have served as a springboard for patient education for many years. We’ve had presidential polyps (Bush, 2007), CABG (Bill Clinton, 2004) and vice presidential heart transplants (Dick Cheney, 2012), just to name a few.
In what could be yet another form of public service, these public figures have allowed their medical history to become a megaphone for the benefits of procedures as well as routine physicals and vigilance. In a statement, Bush’s spokesman said the 67-year-old former head of state “encourages us all to get our regular check-ups.”
There has been much buzz about the appropriateness of Bush’s treatment. Bush apparently did not experience symptoms but the spokesman described the stenting as “necessary.” The debate may never be resolved.
In the meantime, many hospitals and cardiology organizations have used the opportunity to explain to the public what interventions exist and how they work. Efforts to raise awareness of coronary artery disease and symptoms of a heart attack are laudable. The messages also should make it clear that sometimes PCI is not the proper course of treatment.
This is a concept that goes against the grain for some people. They ask when a patient is deemed inappropriate for PCI why “the doctor is doing nothing.” Of course, the physician may be prescribing evidence-based medications, monitoring and recommending ways to modify risk factors that could precipitate an MI.
Here is an opportunity to discuss not only treatment but overtreatment. Cardiology has taken the reins in appropriate use with many initiatives to help specialists determine when a procedure such as PCI is appropriate or not. Perhaps it is time to expand the campaign by better educating the public as well.
Cardiovascular Business, editor