A’s Medical “Fact” of the Day

My sister A, a second-year med school student, occasionally contributes Medical Facts of the Day. Today’s is less gory than usual, which is nice because it means that salmon post I’ve got all geared up to go can bookend what you see below. Without further ado…

I Like Ike… and Rat Poison 

The year was 1955. Dwight D. Eisenhower was vacationing with the in-laws in Denver, Colorado, enjoying some golf when he started experiencing some angina. Later that evening, his crushing substernal chest pain intensified, and he was rushed to the nearest hospital. The coronary artery supplying the anterior portion of Ike’s heart, called the Left Anterior Descending or “Widow-maker’s artery” had been blocked by a ruptured atherosclerotic plaque, causing oxygen deprivation of his heart tissue.

In present times, “crushing substernal chestpain,” the telltale sign of a heart attack, is immediately worked up with an EKG and blood tests for cardiac enzymes, and patients are given sublingual aspirin, heparin, oxygen, morphine, and thrombolytics, and placed on secondary prophylaxis with Coumadin. But back in the day, treatment wasn’t so established. Ike was given oxygen, morphine, and heparin, and lay in bed sick for days at enormous risk of suffering from subsequent MI and death.

Wasn’t there something more we could do for this VIP??? Everyone was wondering. Everyone who knew, that is, since his illness was kept secret from the nation. His doctor, Dr. Paul Dudley White, the “Father of American Cardiology” suggested a new treatment – warfarin. Warfarin had been used as rat poison, where in application it led to thinning of the blood and hemorrhage in rodents. There had been very little research done on human subjects, but the drug’s anti-thrombotic effects seemed promising.

So Dr. White gave rat poison to the president. And the president lived, running for another term of presidency just a year later. Warfarin is now routinely used for patients at risk of thromboembolic disease, thanks to Dr. White, Ike, and any rats injured along the way.

Stay tuned for more Presidents in Medicine. Next up: Honest Abe the…Syphilitic?
(Side note: If you like Lincoln, Chris Sarandon, and history, check out Hour 3 of the PBS series God in America. Vested interests are present here.)
Photo credit: Library of Congress, LC-USZ62-104961
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