Medical mystery: The president was stricken on the golf course

President Dwight Eisenhower and his wife, Mamie, flew to Denver on Aug. 14, 1955, for what he called a "work and play" trip, set to last until October. The couple had long enjoyed Denver, where Mamie's parents, the Douds lived, and had many friends there.

The president especially  enjoyed the mountain air, fishing and golfing, and there was a military base nearby for the working portions of the visit.

About five weeks into the trip, the 34th president teed off on the first fairway of Cherry Hills Golf Club. His game was interrupted repeatedly by phone calls from Secretary of State John Foster Dulles. Called back to the clubhouse for yet another call, the president – known for a rather quick temper – became so agitated that one observer noted that "the veins stood out on his forehead like whipcords."

Then, on the eighth hole, Eisenhower, then 64, started complaining of indigestion, which he attributed to the hamburger with Bermuda onions he had wolfed down between his morning and afternoon rounds of golf.

Nonetheless, he finished the round, returned to his inlaws' home, and went to sleep early that evening, Sept. 23.

He awakened with chest pains early the next morning, and his personal physician was summoned. Howard Snyder, former U.S. Army surgeon who'd known the president since both served in Europe during World War II, examined Eisenhower and observed him closely for hours.

Then, a specialist from nearby Fitzsimons Army Hospital, arrived to examine Eisenhower.

Was the president indeed suffering from indigestion? Or should his personal physician have summoned help right away?

The Fitzsimmons specialist performed an electrocardiogram, which confirmed his suspicion that the president had suffered a massive heart attack. Eisenhower was whisked to the hospital in a Secret Service car. A repeat electrocardiogram confirmed the heart attack on the anterior heart surface.  An irregular rhythm and premature heartbeats were detected.

The president was placed in an oxygen tent, the usual hospital treatment of the time. He was told to expect to remain in the hospital, on bed rest, for six weeks.

"Oh, my God," said Vice President Richard Nixon when he was notified. "When? How bad is it?"

Howard Snyder, former U.S. Army surgeon who'd known the president since both served in Europe during World War II,  along with the president's staff and family agreed to bring in another cardiology consultant. Paul Dudley White of Harvard University, founder of the American Heart Association, flew to Denver immediately.

On Sept. 29, as Eisenhower was lifted out of bed, he experienced a new chest pain. A rubbing sound was heard from the heart, pointing to a complication later confirmed as  pericarditis, an inflammation of the heart's outer membrane.

White was criticized for getting the president moving too soon, but Eisenhower stabilized and continued in the hospital for six weeks. Eisenhower broke with the secrecy usually surrounding presidential illnesses, allowing White to issue periodic updates to reporters on his progress.

Upon discharge from the hospital, he was instructed to stick to a low-fat diet, maintain his weight at 175 pounds, and take 5 mg of the blood-thinner warfarin daily. He had quit his four-pack-a-day smoking habit in 1949.

For several months after his heart attack, Eisenhower went through periods of anxiety, denial and depression common to many cardiac patients.

Eisenhower suggested that Nixon run in 1956, but in the end decided to seek a second term, which he won handily. White told reporters that Eisenhower was fit to serve another term in office, but privately urged the president not to run again. Still, Eisenhower was able to complete his second term. He died in 1969 of congestive heart failure.

Allan B. Schwartz, M.D., is a professor of medicine in the Division of Nephrology & Hypertension at Drexel University College of Medicine.