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Cheney landed in the hospital for several hours early Monday morning with shortness of breath, an ominous symptom in a four-time heart-attack survivor. Doctors immediately had to rule out the worst possibilities, such as a blood clot in the lungs or heart failure
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This time around, Cheney, seen walking with a cane last Friday, may have suffered an attack of gout in his left toe. His office said there has not been a definitive diagnosis, but his personal physician diagnosed the recurring ailment in 2000. Gout is an extremely painful type of arthritis that flares in certain joints, particularly the big toe, when high levels of uric acid — a normal celullar byproduct — accumulate in the blood, faster than the kidneys can eliminate them.
Gout can be treated and prevented with popular painkillers known as NSAIDs, non-steroidal anti-inflammatory drugs that include such mainstays as ibuprofen and naproxen.
But a potential side effect of NSAIDs is to reduce kidney blood flow in a way that allows fluid build-up, which if not alleviated can strain the heart.
Moreover, serious heart disease sometimes strains the kidneys, in turn making them more vulnerable to that side effect, Eckel said.
Cheney won't suffer lasting harm but should avoid NSAIDs, said Dr. Stuart Seides, associate cardiology director at Washington Hospital Center.
"It's not common, but it's certainly not rare," he said of the side effect.
"If I were his doctor, I would be extremely ambitious to try to prevent gouty attacks, more than I might be in someone else, so as not to get into this situation," Seides added, noting that an older drug, colchicine, is a good preventive.
"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," Mayfield said.
A Washington podiatrist, Dr. Stephen Pribut, said that based on Cheney's symptoms he might have gout but quite often foot ailments like this are symptomatic of a mechanical problem that can be treated with shoe inserts called orthotics.
"The problem is the foot problem is harder to diagnose than you think," Pribut said. "I think people go into it with preconceived notions and don't check the entire joint from top to bottom."
USA Vice President Reacts to Gout Medications
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