Gerald Ford Undergoes Cardiac Cath

The oldest living President, Gerald Ford, underwent his second cardiac invasive procedure of the week yesterday at the famed uber-tertiary Mayo Clinic. Rochester, Minnesota’s pride and joy is popular amongst the political sect as several former and current world leaders choose The Mayo for their health care.

Only two days after a permanent pacemaker (and probably AICD) was implanted, the 93 year old Ford underwent cardiac catheterization and percutaneous coronary intervention (PCI), i.e. he got stented.

This is an odd set of circumstances as usually the two procedures are performed in the opposite order. The reason for this is quite logical. If someone were to present with an arrhythmia (e.g. high-degree heart block, v-tach) requiring a PPM/AICD, it is not uncommon to pursue cardiac cath first so as to r/o coronary artery disease as an etiology and also to determine the cardiac risk of undergoing an operative procedure (even if it is one performed by a non-surgeon).

In this case, though, it seems that Ford had the pacemaker implanted first and went for cath second. Possibilities?

- Perhaps following the minor operative procedure, he developed chest pain and made troponins, signaling some level of ischemia and pointing the way towards cath.
- Maybe he presented initially in severe and complete heart block and was just rushed to the procedure because of his name without concern for ischemic complications.
- It is remotely possible that the Mayo docs anticipated that they may have significant issues trying to open up a chronic total RCA lesion which often requires temporary pacing because of the RCA’s tendency to provide blood flow to the AV node.

Whatever the case may be, Ford is now resting comfortably in his private Mayo-ral room with two tiny stents propping open one of his coronaries and silver dollar-sized device stimulating his heart to beat.