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Panel Discusses Heart Disease

Aired March 8, 2005 - 21:00   ET


LARRY KING, HOST: Tonight, staring down America's No. 1 killer with the stars who survived it, coronary heart disease. It struck former "Charlie's Angel" Kate Jackson, comedy legend Phyllis Diller, celebrating 50 years in show business this week. And at age 23, Backstreet Boy Brian Littrell had to undergo heart surgery. This hour could save your life from a killer that can hit anyone at any age. Even hit me. It's all next on LARRY KING LIVE.
Joining us now in Orlando, Florida, where I'll be on -- where I was on yesterday morning, rather, Dr. Pamela Douglas, the new president of the American College of Cardiology. Dr. P.K. Shah is the internationally renowned cardiologist, director of the division of cardiology at Cedars Sinai. Here in Los Angeles is Kate Jackson. Kate underwent cardiac surgery as an adult to correct a hole in her heart. She's a past recipient of the American Heart Association's Power of Love Award for her ongoing effort to increase public awareness of heart disease.

Phyllis Diller, the ageless comic actress, artist, author of a terrific new autobiography, "Like a Lampshade in a Whorehouse: My Life in Comedy." Phyllis is celebrating her 50th anniversary in show business. There's a great documentary about her career titled "Good Night We Love You." She suffered a heart attack in February of 1999, was implanted with a pacemaker the following month. Brian Littrell -- you'd be shocked to find him on this show, he's so young -- he's a member of the Backstreet Boys. The Boys are about to head out on tour and will release their first album in five years come June. He was born with a congenital heart problem, had open heart surgery in 1998 to correct the defect, founder of the Brian Littrell Healthy Heart Club for Kids.

Dr. Douglas, why cardiology?

DR. PAMELA DOUGLAS, PRESIDENT, AMERICAN COLLEGE OF CARDIOLOGY: Because it's fascinating field where you can actually help people. You can take people who have heart disease and make them well. You can take people who are at risk for heart disease and prevent the disease from ever happening.

KING: The advances have been incredible in the field, right?

DOUGLAS: The advances are fabulous. And it's that blend of technology and care of patients, high-tech, high-touch, that's very attractive.

KING: Let's find out about each of these patients here tonight, our props. Kate, what happened to you?

KATE JACKSON, FORMER "CHARLIE'S ANGELS" STAR, HAD ADULT CARDIAC SURGERY TO CORRECT HOLE IN HER HEART: I was born with an ASD, or an atrial septal defect, a hole in my heart. It wasn't discovered until about 11 years ago. I had open heart surgery. It was corrected and...

KING: You had no complications from it?

JACKSON: No, I have a perfectly normal heart now. But up until then...

KING: I mean all your life, you had a hole in your heart?

JACKSON: No, you know what? The only time it ever -- that I ever had a clue that there might be something wrong was when jogging became a craze. I wondered why I could work out in the gym for two hours but I couldn't jog around the block. That was the only thing I ever noticed.

KING: And how did they pick it up?

JACKSON: Actually, a friend of mind, Dr. Gerald Pohost (ph), who's at USC now, heard it with his stethoscope.

KING: Heard it with his stethoscope?

JACKSON: Heart it with his stethoscope, yes.

KING: Is this common, Dr. Shah?

DR. P.K. SHAH, DIR., CARDIOLOGY DIVISION, CEDARS SINAI MEDICAL CENTER, LOS ANGELES: It's a fairly common congenital heart defect, where the wall between two upper chambers is not fully formed, leaving a hole connecting the right and the left side of the heart. Nowadays, we close them in most cases without surgery.

KING: What?

SHAH: Without surgery. What we do now is we have special devices that we mount on top of a catheter, and under local anesthesia, you go up through the groin all the way carrying this device on the tip of the catheter. And under X-ray and ultrasound guidance, you guide it into the right side of the heart, across the hole then pull it back, and a disk-like structure closes this side of the hole. And then on this side, you put another disk. And you remove the catheter, the hole is completely sealed. And it usually takes an hour, hour-and-a-half and...

KING: Why didn't you wait, Kate?

JACKSON: That's amazing!


JACKSON: I should have waited. KING: So they went in and opened -- they opened you up, right?

JACKSON: They did -- yes, I had open-heart surgery.

KING: So this is fairly new?

SHAH: This has been in the last six to seven years. It's now becoming pretty close to standard way of treating most holes in the upper chamber of the heart. Not every one of them, but the majority can be closed successfully without surgery. Patient is out the next day.

KING: Common to you, took, Dr. Douglas?

DOUGLAS: Absolutely.

KING: So this is not something strange, to have a hole in the heart?

DOUGLAS: It's fairly common, and exactly what Dr. Shah says, that we have technology now to be able to close it without an operation, without open heart surgery.

KING: Now, Brian Littrell, you're so young. What happened to you?


KING: What's that?

LITTRELL: ... a ventricular septal defect.

KING: Meaning?

LITTRELL: Meaning a heart murmur. It was -- like Dr. Shah was referring to, it was high up in the tissue in the wall between the left and right ventricle. And what was happening was in my early 20s, they discovered that there was literally backwash that was happening between my left and right ventricle, which was causing my heart to enlarge.

KING: Did you know it when you were a kid?

LITTRELL: I knew I was born with the heart murmur. I had a bacterial infection when I was 5 years old in 1980. I was hospitalized for two months. Later on in life -- I was not supposed to live from the endocarditis that I had. It's a miracle that I'm walking here today. But to be a part of the Backstreet Boys and do a two-hour show every night -- when they discovered that my heart was enlarging, we went back and went to the Rochester Clinic -- in fact, the Mayo Clinic in Rochester. And they decided to do surgery -- we decided to do surgery. And the surgeon, Dr. Danielson (ph), discovered a hole in my tricuspid valve, where the endocarditis had set up shop. KING: Are you OK now?

LITTRELL: I'm perfect now. Everything is great. But I did have to be opened up straight through the sternum. He's talking about six or seven years. It's been seven years. I wish I would have talked to Dr. Shah!


KING: They doing it that definitely now, too?

SHAH: Well, the type of hole that Brian describes is not the type that Kate had. Kate had a hole in the upper chambers of the heart. Brian, based on what he just said, he had a hole in the bottom chambers of the heart. Now, those are not as easily amenable to a closure with catheter. Although many of them can now be closed, but many of them do require surgery.

KING: Now, Kate said hers was picked up by a stethoscope. Does that mean other doctors never picked it up?

SHAH: It's not very unusual for us to see that holes in the heart, especially the upper chambers of the heart -- people with holes like that can live into the 60s, 70s and be diagnosed only in the 40s or 50s. And the diagnosis is often missed because the heart murmur is pretty inconspicuous. But there are findings on electrocardiogram and the chest X-ray which, in combination with the peculiar heart sounds that you hear, can help us make the diagnosis.

KING: Do you have any repercussions at all?

JACKSON: None. None at all.

KING: Have to take any medication at all?

JACKSON: Nothing. No. I'm just fine.

KING: Brian?

LITTRELL: No, sir.

KING: No medications?

LITTRELL: No medications.

KING: Do you have to go for regular check-ups?

LITTRELL: Yes, I do.

KING: When we come back, Phyllis Diller will give us the dramatic story of her heart attack. Don't go away.


WILLIAM JEFFERSON CLINTON, FORMER PRESIDENT OF THE UNITED STATES: I feel fine. You know, I found this condition when I did my regular tests. And they said I was in the top 5 percent of men my age in health, but they took a routine X-ray and found out that I had a lot of fluid built up here, which is quite rare, once the fluid goes down. And so all they have too do is drain it and take that little peel (ph) that holds the fluid out. It's a routine sort of deal, and it'll knock me out of commission for a week or two, then I'll be back to normal. It's no big deal.





CLINTON: Not really. I mean, I'm going to slow down for the next couple of weeks. But I'm in good shape. I got a good grade in my health test. I just have this little fluid built up. As soon as I get it done, I'm going to go back to work.


KING: We're back on this edition of LARRY KING LIVE looking at heart disease. I have my own Larry King Cardiac Foundation, which I started after I had a heart attack and heart surgery. And all these people are actively involved in it, both working with it, helping it and being involved as patients.

What happened to you, Phyllis?

PHYLLIS DILLER, COMEDY LEGEND, FITTED WITH PACEMAKER AFTER 1999 HEART ATTACK: Well, I was born with a heart murmur. And it didn't interfere with any of my life until I was quite old. The first thing I noticed was after a long air trip, I would be dizzy in the airport, and often dizzy spells then. I'd simply put my head down and get the blood up there. But what really happened was I started falling down, just out like a light, for no reason at all.

KING: Like, fainting?

DILLER: Well, it wasn't like a faint, it was just out. And then one night, it went 150 to -- you know, the pulse, for eight hours and it made me very nervous. And I checked myself into St. Johns. And that's when all hell broke loose. It's called congestive heart disease. It all has to do with Fidel Castro.

KING: How old were you when it happened?

DILLER: Let's see. If I'm 88 now, it was four years ago, 84.

KING: Is that rather late to discover, Dr. Shah, you have a heart problem?

SHAH: No, not necessarily. I think -- as you get older, the risk of various rhythm disturbances of the heart increases. In fact, what Phyllis describes it atrial fibrillation is one of the most common arrhythmias, and the frequency increases with age. But it's -- that causes a rapid heartbeat, and rapid and irregular. But what Phyllis is also describing is that she was fainting, and that happens when the heart suddenly slows down or temporarily stops.

DILLER: It stopped.

SHAH: And sometimes you have -- at one moment, heart goes very rapid and irregular. The next moment, it slows and stops. That's called bradytachy syndrome. Those individuals often need a pacemaker to correct the slow problem...

KING: Which you have now, right?

DILLER: I have a pacemaker.

SHAH: ... and medication to correct the rapid problem. And it's a fairly common condition.

KING: Dr. Douglas, is it fairly common surgery on an 84-year-old individual?

DOUGLAS: Well, as P.K. has said, pacemakers become more common later in life because the electrical impulses in the heart tend to get more feeble and not conducted as well. So older people need peacemakers much more than younger people.

KING: And what does the pacemaker do, Dr. Douglas?

DOUGLAS: The pacemaker makes sure that the heart beats on time because the intrinsic cells that create a heart rhythm can get a little forgetful as we age, and the pacemaker can remind them that it's time to squeeze and get another heartbeat in there and pump more blood out to the body.

DILLER: Well, now, I just recently had that next procedure to -- because it was fibrillating again, going poo-poo-poo-poo-poo. And then they did that thing where they go into the heart with the electrical shock to cure the fibrillation, which they did, and now they say it's not fibrillating.

SHAH: Very good.

KING: Meaning?

DILLER: It's who?

KING: Meaning it's good?



KING: I'm sorry, Doctor. Go ahead.

DOUGLAS: That's a new technology called oblation of a heart rhythm, where a catheter goes up through the vein in the leg and up into the heart and produces very teeny, tiny burns in an area of the heart that is causing the arrhythmia or the heart rhythm problem, and by causing that tiny scar, almost microscopic can get rid of the abnormal heart rhythm and actually cure the illness.

KING: Where is your pacemaker?

DILLER: It's right here. They usually put it on the left side, unless you're left-handed. But the thing is, they didn't go up my leg or anything, they just went down my throat for this last electrical thing. What about that?

KING: Is that surprising you, Dr. Douglas?

DOUGLAS: Well, I'm not exactly sure what procedure Phyllis is describing. She may have had an echocardiogram to look at the upper chambers of the heart and make sure there were no blood clots.

DILLER: No, she did some -- she gave my heart a shock.

DOUGLAS: And then had a cardioversion with -- just with external paddles.

DILLER: I believe that's...

KING: Now, what does...

DILLER: I was asleep.


KING: What does Dick Cheney have?

SHAH: Well, Dick Cheney had a pacemaker with a defibrillator function. And that device is kind of the Cadillac of pacemakers, that if your heart goes too slow, the pacemaker will kick in and produce a heartbeat. And if the heart goes too fast, particularly the more dangerous type of rapid heartbeat, which essentially stops the function of the heart, what we call a ventricular fibrillation -- if you don't correct it, you die. Within two to three minutes, you're dead. So the defibrillator senses that and rapidly delivers a shock internally and restores the normal rhythm back...

KING: Do you favor defibrillators on airplanes?

SHAH: I definitely do. In fact, the smart defibrillators are so idiot-proof and so easy to use that it takes five minutes to train an individual how to use them correctly.

KING: You could train Phyllis Diller...

SHAH: Without any question.

KING: ... how to come to an aid of a person on an airplane with a defibrillator?

SHAH: Without any doubt. DILLER: Oh, boy! That'd be neat.

KING: Save someone's life. Wouldn't that be...

DILLER: Yes. Why don't I have that -- what Dick Cheney has?

KING: OK, why don't we all have what Dick Cheney has?

SHAH: Well, first of all, you have to be at risk for ventricular fibrillation, which is the mechanism for sudden death. If you're not at risk, then it doesn't pay to go through a very invasive procedure to have the defibrillator implant. So we give it to people who we perceive have a risk of having a life-threatening arrhythmia.

KING: What's the success rate?

SHAH: Excellent. It will shock you almost every time that you get that fatal arrhythmia and...

KING: It shocks you. You feel it.

SHAH: Absolutely. Most of the people will feel it.

KING: We'll be right back with more. Don't go away -- on this edition of LARRY KING LIVE.


KING: You looked so great. You'd lost so much weight. Didn't you think that if you had a problem, it was over?

CLINTON: Well, no. And we'd -- I'd also been treating the high cholesterol, and then I stopped taking that medicine because I got my cholesterol down low. And I had in the past had a little blood pressure problem, which I treated, and then I got it down. But you know, some of this is genetic. And I may have done some damage in those years when I was too careless about what I ate. So for whatever reason, I've got a problem and I've got a chance to deal with it, and I feel that I really got to -- let me just say this, that republicans aren't the only people that want four more years here.





DR. HERBERT PARDES, NY PRESBYTERIAN HOSPITAL: Former president Clinton will be undergoing a procedure this week to remove some fluid and scar tissue from his left chest cavity. The procedure, which is a recognized occasional consequence of open heart surgery, will take place Thursday at New York Presbyterian Hospital, Columbia University Medical Center. He will remain in the hospital for somewhere in the nature of three to ten days. (END VIDEO CLIP)

KING: We're back with our panel. I'll reintroduced them in a while.

Kate Jackson, has this caused you any changes in your life?

JACKSON: I think my ASD was a blessing in disguise because it taught me to know the risk factors of heart disease and to stay away from them. It taught me how to eat a proper diet, to stay away from fat, saturated fat, to eat chicken and fish instead of red meat, to eat tub margarine instead of butter. It taught me to exercise 30 minutes a day, and if I couldn't in one 30-minute chunk, in three 30- minute chunks. And it taught me about tobacco use, which I didn't smoke anyway, but it taught me that you're three times more likely to have a heart attack if you do smoke.

KING: But you don't have high cholesterol, do you? You didn't have the standard blockage heart attack.

JACKSON: No. You know, I have hereditary high cholesterol. I do...

KING: Oh, you do?

JACKSON: My diet -- I really do control it with my diet and my exercise, yes.

KING: Do you take medication?

JACKSON: No, I don't have to.

KING: You don't take the statins and -- aren't the Lipitors and the like amazing, Dr. Shah?

SHAH: Yes, for lowering the...

KING: Aren't they revolutionary?

SHAH: Lowering the LDL cholesterol, statins are remarkably effective. And for people at risk, we do recommend those medications.

KING: How involved are you with the heart, Brian? What this is the Healthy Heart Club for Kids?

LITTRELL: We create a healthy heart lifestyle. Kids today go to school, they come home and then they want to play video games in front of their television. They don't want to exercise. Obesity is a major thing in our country that we're trying to tackle. And in our youth, people need to know, kids need to know. And we're not just marketing -- we're not targeting the kids, we're targeting the parents. We're targeting the families because this is -- we create a heart-healthy lifestyle. That's what the Healthy Heart Club does.

And it's amazing. I mean, we give -- we raise funds. The Backstreet Boys fans have been amazingly generous. They hold fund- raisers and they send money to the club. And it's just a wonderful, wonderful experience to be so tightly involved with these families and are going through -- sharing the same experiences that I've been through, so...

KING: Do you have a Web site?

LITTRELL: Yes, I do.

KING: What is it?


KING: Did you ever feel cursed to be born with this? I mean, did you ever, like, Why me?

LITTRELL: No, I didn't. I look at it as blessing. I think...


KING: Because I knew Bobby Darin. You know, he knew hew as going to die you.


KING: He was born with a -- rickets they called it. What do they call it now?

SHAH: Rickets is a vitamin D deficiency.

KING: Yes, but it affected his heart. And he knew -- they thought he would die at 15. Rheumatic fever.

SHAH: Rheumatic fever. That's different, OK? That's different from rickets. That's caused by streptoccal infection and...

KING: Is rheumatic fever a death sentence?

SHAH: Not necessarily. You can prevent it and you can treat it. And it usually -- it licks the joints but eats the heart. It damages the valves of the heart, so you got narrowing or leakage in the valves.

KING: Dr. Douglas, how much of heart problems are you born with, percentage-wise?

DOUGLAS: A very small percentage of heart problems are the ones you're born with. It's what we do to ourselves in our society with, as Kate said, not eating right, not exercising and so on, that really creates the burden of heart disease that we have in our country today.

KING: Do you know why, Kate, we are technically suicidal? Because that's what we are.

JACKSON: Heart disease is a choice. It really is a lifestyle choice. It's almost as if you raise your hand and say, Give me heart disease, please. I'm going to smoke, and I'll eat fat and I'm not going to exercise at all. It's a lifestyle choice. It's amazing, isn't it, when you know that and you continue to do the things that will lead right to heart disease.

KING: Can you get better, Dr. Shah?

SHAH: In terms of what?

KING: I mean, you can't improve, if you have heart disease, right? You want to maintain.

SHAH: No. You can -- there are certain forms of heart disease that are completely reversible. There are...

KING: Reversible?

SHAH: Absolutely. There are certain that are completely manageable, and there are some for which there is no treatment or cure. And ultimately, some of those require transplantation.

KING: Who needs a transplant?

SHAH: A transplant is usually done for two main reasons. One, that your heart muscle is so weak that it's unable to function, and your body basically is deteriorating. It's not getting enough blood despite all the medications and everything. Those are the individuals that require a new heart. The second, less common indication is when you have such serious and recurrent and repetitive bouts of irregular rapid heartbeat, so your defibrillator is shocking you 30 times a day. You can't live like that, so then you basically remove that heart and try to put in a new one. That's a less common indication.

KING: How many people now in this country, do we know -- Dr. Douglas, do we know? You're president of the American College of Cardiology. How many people have new hearts? Dr. Douglas, do you know?

DOUGLAS: I don't know. I would say it's about 2,000 or 3,000 across the country.

KING: And is it now a long lifespan?

DOUGLAS: It's now not quite a normal lifespan. There's about a 90 or 95 percent survival at the end of one year.

KING: What do they have to overcome, the infection?

DOUGLAS: Well, there's not necessarily infection, but the medications that we need to give these patients so that their bodies don't reject the heart that they got, the new donor heart, are very powerful medications with a lot of side effects, and that's the biggest problem.

KING: Dr. Michael DeBakey told me once, Dr. Shah, if we took all the money spent on the Vietnam war, spent on the technical people, the people who build bombs and everything, and gave them the problem of an artificial heart, you'd have one today for $50. SHAH: I don't know about $50, but there are many different iterations of artificial hearts that are currently used, either as bridge to transplantation, or even as permanent fixtures. Michael DeBakey has actually contributed to this field enormously. In fact, one of his recent iterations of an artificial heart is about the size of a finger or slightly bigger than that, that works on the principle of the Archimedes screws. So it is like a turbine. It generates blood flow. And it's very small, and it can be even used in kids as either a temporary or potentially a permanent replacement.

KING: We take care of ourselves, we're going to live forever, and then that's a problem.


KING: We'll be right back.


GEORGE HERBERT WALKER BUSH, FORMER PRESIDENT OF THE UNITED STATES: Physically, I'm up for all this stuff. I mean, maybe someday, we'll go off to the area, if that's what they expect us or want us to do.

KING: What about you, President Clinton?

CLINTON: Come on, Larry!

KING: Come on what?

CLINTON: Yes, you ought to be asking me if I'm to it. He in better shape than I am. I'm having heart surgery, he's jumping out of airplanes, and you're asking me...


CLINTON: I don't know if I'm up to it. I'm just going to try to -- my whole goal here is to learn how to be in the shape he's in when I'm 80. That's one of the things I try to do. All I ever want out of this personally is learn that while we're doing it.




CLINTON: I'm not in too bad a shape. I feel good about it.

BUSH: You should have seen him going town to town, country to country, Energizer Bunny here killed me. If this thing, whatever he's got if it knocks you out, it hasn't got to him yet.


KING: Welcome back to LARRY KING LIVE. Our guests are Kate Jackson, who underwent cardiac surgery as adult to correct a hole in her heart.

Phyllis Diller, author of "Like a Lamp Shade in a Whorehouse: My Life in Comedy" has suffered a heart attack in February of '99, has a pacemaker.

And Brian Littrell, a member of the Backstreet Boys. He was born with a congenial heart problem, open heart surgery performed in 1998 corrected the defect.

Dr. P.K. Shah, the internationally renowned cardiologist, director of the Division of Cardiology at Cedars-Sinai.

And Dr. Pamela Douglas, she is chief on cardiology at Duke University. You're also professor of what?

DOUGLAS: I'm Ursula Geller professor of research and cardiovascular diseases.

KING: Are more young people interested in being cardiologists?

DOUGLAS: Plenty of people are interested in being cardiologist. It's an exciting field.

KING: Many women in it?

DOUGLAS: Not very many women. Very few women, as a matter of fact.

KING: That's right, because I think it's almost -- you hear the term, there's a heart doctor, you think male. Why is that?

DOUGLAS: Well, only 6 percent of cardiologists are women. And it's not entirely clear why that is, but it's something I hope to fix as president of the American College of Cardiology.

JACKSON: We should probably also say too, that heart disease up until fairly recently was thought of as a man's disease. And that nine out of 10 women don't know that heart disease is the number one kill over women.

KING: More than breast cancer?

JACKSON: Absolutely. Yes.

DOUGLAS: Kate's right. Half of all women -- almost half of all women will die of cardiovascular diseases, just like half of all men.

KING: Why then does it get, Dr. Shah, get less attention? You think heart attack you think women -- you think man.

SHAH: Well, women have three strikes against them. First, they don't believe that they're at risk as Kate just mentioned, so they ignore their symptoms. Their spouses don't believe them when they complain. And their doctors don't believe them when they complain.

KING: Doctors... SHAH: Absolutely. And therefore, what is happening, women, until very recently were not diagnosed in time, were not treated in time, and therefore were suffering major cardiovascular events. In fact, recently the statistics is that more women die of heart disease than men in the U.S. Slightly more women actually die of heart disease then men in a year.

KING: Wouldn't you think therefore we'll have more female cardiologists coming along? Usually there is a connection.

SHAH: Well, as you know, American Heart Association and American College of Cardiology have gone on a campaign called "Go Red For Women." And the goal is to increase awareness among women that they need to ask the questions of themselves and of their physicians, are they at risk? What should they do if they're at risk? How can they modify their risk for heart disease? Because as Kate Jackson just mentioned, if you poll women and ask what do they fear most, it's breast cancer. They don't know that most of them will die of cardiovascular disease long before getting breast cancer.

KING: Smoking is way down in America now, isn't it?

DOUGLAS: It's down but up in teenage girls. Just that group that is at risk for developing heart disease when they get into their '50s and 60s and 70s.

KING: Do you know -- have we studied what lures them to smoke?

DOUGLAS: Partly because it's cool, partly because it's weight loss. That's an important component of it.

KING: That's a myth, though, isn't it?

DOUGLAS: It is a little bit of myth. But girls do it because they want to be attractive.

KING: But isn't it a myth by smoking, you will not gain weight?

SHAH: That's not a myth, it's a fact.

KING: So, smoking will cut?

SHAH: In general, if you quit smoking, you tend to gain weight, so which tells us smoking does curb weight. In fact, to expand on what Dr. Douglas mentioned, besides being cool, it is addictive. There are parts of the brain that are stimulated by nicotine, that create a further craving for more nicotine. So, it's a self- perpetuating vicious cycle.

KING: Now, Phyllis, at your age, you're not going to change your lifestyle are you? Have you changed your diet?

DILLER: No. I have always eaten right.

KING: Oh, you've always been a...

DILLER: Well, I'm a fruit/veggie type.

KING: Oh, you're ahead of your time then?

DILLER: Well, my mother was way ahead of her time. She would not allow smoking. I mean, it was out. She would give me a hot toddy (ph) for cramps, but cigarettes are out. She was so right. Well, let's face it. The cigarettes used to be called coffin nails. Wouldn't that be a straw in the wind?

KING: Do you -- do you -- Brian, do you know any, like, adult who would say, I think I'm going to start smoking, like a 27-year-old guy. Why not, let's smoke.

LITTRELL: No. No. I mean, smoking is very bad for you. Like Dr. Shah was saying, I mean, smokers that I know, they go out and have dinner. And then what happens after they eat, they go and have a cigarette. It's almost like an appetite...

KING: I smoked three packs a day for 30 years, day of the heart attack stopped and never wanted one again. Was I scared?

SHAH: Absolutely.

KING: What happened to me, I got scared to death?

SHAH: You got religion finally. You joined the club.

KING: Nothing -- nothing anybody said worked. With this show, I would hit the clicker.

SHAH: It's a shame it's usually heart attack or a stroke for a person quits. That's a shame that they don't quit before that.

LITTRELL: But how is your look on life now? I know you ask all the questions, but...

KING: I used to think smoking was the -- you know, I could never stop smoking. Are you crazy? Stop smoking? (UNINTELLIGIBLE) smoking.

JACKSON: I smoked for about a year when I was a teenager.

KING: Oh, boy. I smoked in the shower. I kept it lit on the soap dish. I smoked on this program. The cigarette would be under here I smoked -- you know, in television in '60s you smoked on the air. Every watch the old shows? Carson show he smoked. Mike Wallace used to smoked. I used to keep a lit cigarette -- keep it lit so I didn't have to wait to light it. Keep it lit under here.


KING: With my hand on it. And as soon as I say, we'll be right back.

JACKSON: You know, another thing that's very bad is second-hand smoke. I have a friend who when you could still smoke on the airplane was sitting next to a gentleman who turned to him and said, excuse me, but do you mind if I smoke? And he said well, you may burst into flame if you light, but not next to me.

KING: Yes, we -- we on an airplane...

JACKSON: Forgot (UNINTELLIGIBLE), that was just murder. I couldn't even imagine...


KING: I used to sit and hold a cigarette with the lighter waiting for the light to go out.


KING: Some pilots wouldn't turn the light out until like 30,000 feet. What are you waiting for? You know, come on, I can't live without this.

LITTRELL: You were messing with the smoke detector in the laboratory weren't you?

KING: I would have -- I would have said the sign is a fake. There's no -- why would the airlines need the money, they'd just put a sign up. You know, go to -- I'd have been arrested. Because I was -- I know what it is to be addicted. I was addicted to tobacco.

SHAH: Each cigarette smoke takes away seven minutes of your life expectancy. Each cigarette.

KING: Seven minutes? I'm 148-years-old. We'll be right back. Don't go away.


CLINTON: I've had some difficulty ever since I got out of the White House and getting my distance up in running. And I just had a feeling a couple days ago, I had to have it checked. When I finally got tightness in my chest and I hadn't done any exercises, the first time that ever happened to me. And we did this angiogram, and found I had blockage that was too significant to open and put a stint in, we had to do the whole surgery. So, I'm trying to get my whole head in the game.




CLINTON: If this isn't good for my heart, I don't know what is. Thank you.


KING: We're back. Before your surgery, Kate, how nervous were you?

JACKSON: Well, you know, I actually wasn't all that nervous. I had great faith in my doctor, Gerry Pohost (ph) is a friend of mine, and in fact, he's my son's godfather. And I had great faith in -- that everything would be fine.

I wanted to do two things, and I wanted to try to remember if I had an out-of-body experience. And I wanted to try to remember not to pull the tube out of my throat when I woke up. If I had an out-of- body experience, I don't remember it.

KING: I didn't have one.

JACKSON: But I did remember not to jerk on the tube when I woke up.

KING: That's a big thing, that tube -- that tube down your throat is annoying.


KING: You don't have it. You administer it, but you don't have it.


LITTRELL: You have a scratchy throat for a little while.

KING: Oh, for a month.

Were you scared, Brian?

LITTRELL: I was scared. I told the doctors to double up on my medicine going in, just for the anticipation, because I was petrified. I was a young man...

KING: That night before...

LITTRELL: I was 23 years old.

KING: The night before open chest surgery is a scary night.

LITTRELL: Yes. And just like Kate was saying, you know, an out- of-body experience or what you remember. I remember -- I don't remember greeting my family the morning of surgery, but they came in and I was in the best of spirits, and then they brought the operating bed, and the table to wheel me in. And they laid me on there and I just busted out crying.

KING: Really?

LITTRELL: And I remember feeling, I remember feeling the threshold of the elevator, with the wheels as you were laying on it. And it was literally like watching a music video that we film in the entertainment world, you know, you see the lights flashing, and it's a realistic thing. KING: Because as a veteran of plastic surgery, nothing bothers you, right? They can bring you in for anything, right?

DILLER: Listen, I spent half my life on the gurney.

KING: Put in a pacemaker, it don't matter.

DILLER: That's the least, please.

KING: Dr. Douglas, is Viagra a menace to heart patients?

DOUGLAS: Viagra doesn't mix well with one of the major medications that we use for treating heart disease, with nitroglycerine and nitrates. And that can drop your blood pressure dangerously. There have even been some deaths.

KING: You have got to watch that, right? Because why? It increases the blood flow, Dr. Shah?

SHAH: What -- nitroglycerine lowers blood pressure, Viagra lowers blood pressure, and the two together can lower the blood pressure to a level where it can be life-threatening. So it's a very dangerous combination.

But I also want to point out that Viagra is being used successfully for certain forms of heart disease, when the pressure of blood in the lungs is so high that the right side of the heart cannot really pump enough blood through the lungs. It dilates the blood vessels in the lungs, allows the right side of the heart to pump more blood.

KING: So you'd give it to that person without sexual connotations?

SHAH: Correct. It's not for that reason, but it's for what we call pulmonary hypertension, when the blood pressure in the lungs is extremely high, and life-threatening levels, Viagra can help.

KING: Dr. Douglas, do you favor people carrying around aspirin, and they say if you have a heart attack, take a bunch of aspirin?

DOUGLAS: Well, absolutely, if you're having a heart attack or having chest pains that you think are a heart attack, you child chew an aspirin, not swallow it but chew it, because it gets into your bloodstream much faster.

KING: And what does it do?

DOUGLAS: It thins the blood out and keeps the blood from clotting, so it will help any plaque rupture that has started to cause a heart attack and attracts the blood cells that form blood clots. It will break up that clot and restore normal blood flow down the heart.

KING: When I had my heart attack, they gave me TPA. It was then experimental. Now it's on ambulances, right?

SHAH: That's correct. It's a clot dissolving medication. It actually dissolves -- breaks down the clots.

KING: It was an intravenous...

SHAH: Correct.

KING: You have -- you take Coumadin, right?

DILLER: Yeah, I am right now.

KING: Do you like -- that's a drug that -- what does that do?

SHAH: Coumadin is rat poison. It actually...

DILLER: Rat poison! And I thought she liked me!

SHAH: It actually prevents the blood from clotting. It's what we call an anti-coagulant. And people who have fibrillation in the top chamber of the heart, they tend to form blood clots in the top chambers, which can travel and trigger a stroke. And Coumadin actually prevents that from happening, it's a very important medication for patients with chronic...

KING: And it's rat poison?

SHAH: It is actually rat poison.

LITTRELL: Do you run into problems with, you know, diabetic patients when you're talking about a medicine that causes the blood to push so fast and it doesn't clot? I mean, when you're dealing with diabetics?

SHAH: Well, it doesn't have any interaction with diabetes, it's purely an anti-coagulant, so it just thins the blood sufficiently that it doesn't have a tendency to form clots.

KING: Diabetes is a big precursor of heart attacks, right?

SHAH: Correct.

KING: Because?

SHAH: Because diabetes creates havoc with the arteries. If diabetes would not be a problem if the arteries were not damaged. The arteries get damaged, and cholesterol build-up in the arteries is accelerated.

Being a diabetic is being like 10 years older than you are physiologically. It ages you prematurely, and that accelerates the pace at which arterial blockage occurs. So diabetics are at extremely high risk of cardiovascular disease.

KING: Dr. Douglas, how long before we are going to keep people alive to 100?

DOUGLAS: We're almost there. The life expectancy for women is well over 80 years, and for men is just about 79 something. And it depends on lifestyle, again. Just as Kate said, heart disease is a healthy choice, and longevity a healthy choice.

LITTRELL: You're 144, you said?

KING: No, I'm going to be 144 based on the seven-minute profile.

We're going to have a problem, though, of aging, aren't we, Dr. Douglas, if too many people live to 100?

DOUGLAS: Not if they're healthy people. If they're healthy people, that would be wonderful. We're doing a lot of research on how people age in a healthy way and what are the physiologic properties in the body, the heart cells that repair blood vessels that are damaged. Why do we lose that ability to repair when we get older? And what can we do about preserving that, so that people who are 90 can have blood vessels of people who are 20.

KING: What's the effect of stress, Dr. Shah?

SHAH: Well, stress is an important factor. It can bring on or precipitate heart disease in a patient who is already at risk for it. And in many different ways, it can trigger a heart attack in someone who already has plaque build-up in their arteries.

And one particular aspect of stress is peculiar to women. Ordinarily, you think they give stress to everybody else. But in this case, they actually suffer a very peculiar type of temporary heart damage, which is very life-threatening and very severe in response to a sudden life stress, such as death of a spouse, or some extreme emotional upheaval triggers a surge of adrenaline in the body and paralyzes the heart into inaction. So the heart acquires the shape of the Japanese octopus catcher, OK? Japanese use a certain-shaped vessel to catch octopus, and the heart assumes that shape when they get this peculiar stress.

Luckily, if you take care of them during the acute phase, they survive, and the heart function fully recovers. This is stress- induced cardiomyopathy, peculiar to women, particularly women.

KING: We'll be back with our remaining moments right after this.


KING: Are you a little frightened?

CLINTON: Well, not as much as I thought I'd be. You know, I don't -- I grew up, as you know, in a home where my mother was an anesthetist. I knew doctors, I knew surgeons. I think the first time I ever saw any serious surgery, I was about 12 years old. I know what's involved, and I know what the options are. I mean, I think that there's virtually -- my blockage is so substantial, I think if I don't do this, there's virtually 100 percent chance I'll have a heart attack.



CLINTON: We ought to have a lot of these examines, that you've got early warning signs that you can get your cholesterol and blood pressure down. That's a big thing. And then, at some point, I understand why there's a reluctance to do angiograms, their an invasive surgery. But aced, and I stress that, four or five years in a row. And ever year I was in the White House, and ever year since. So, that's more than four or five years. So, about 10 percent of the people, for whatever reason, if are in good enough health, if they just do fine on the stress test, and they still have a problem. And I was one of them.


KING: We're back. The Bill Clinton case -- could that have been prevented?

SHAH: There's no question in my mind, that if President Clinton had taken care of himself better and taken the medications to address his cholesterol problem for a longer period of time, it's quite possible that progressive narrowing of his arteries could have been delayed, postponed or even prevented, in which case he may not have needed the bypass surgery. By the time he presented himself and had the angiogram, my understanding, is all major arteries in the heart had serious blockage. So, he didn't really have a choice at that time.

KING: Now, he was lucky not to have a heart attack then?

SHAH: Very much so. Because a lot of people, 40 to 50 percent of the time, Larry, the first manifestation of coronary disease is a major heart attack or sudden death. You don't get a second chance. So, the first manifestation can be heart attack or sudden death.

KING: Dr. Douglas, who survives a heart attack and who doesn't?

DOUGLAS: Well, the person that gets to the hospital has a much higher chance of surviving a heart attack. And a man has a much higher chance of surviving a heart attack than a woman.

KING: Why?

DOUGLAS: We don't know. It may be because women delay in seeking care for their heart symptoms or they're doctors put them off and tell them it's not really their heart, so that they're sicker by the time they come to treatment.

KING: So, in other words, if you have a heart attack on a ski slope, you're worse off than having it at the hospital or on the way to the hospital?

DOUGLAS: Absolutely. Because there's a risk of fatal heart rhythm problem early on in a heart attack that can be treated very effectively with a defibrillator, if you're in range, if you've got somebody there to take care of you. JACKSON: And you know, women's heart attacks are -- the symptoms are different than those of men. It could present itself as a classic movie heart attack, where you grab your chest and you keel over. It could be nausea, dizziness, pain in the lower back. Could be a number of things that, we're women, we're too busy to bother with that. We've got soccer practice to pick the kids up from.

KING: What was the number one problem you had with your disease?

LITTRELL: With my disease? I never really had any physical problems. I was able to do and go and proceed on like a normal life. The only thing was the doctors and specialists told me, if I want to become a father and have a family, and be here for a long time, I needed to look at this and assess it now.

KING: But you had no pain, no chest pain, no manifestation?

LITTRELL: I periodically would have chest pains, but it was nothing that was ever, you know, a problem. I would always, as a young boy, I would tell my mom, it would feel like a little prick in my chest, and then like a radioactive little wave that would run across. But nothing -- nothing more than that, so.

KING: Phyllis. Do you feel like you beat the game?

DILLER: Not really. I'm still working on it. But you know what, if I die tonight, I've had one hell of a life.

KING: You -- what a ride. Do you have children?

LITTRELL: Yes, and do I have children. I have a son that's two years old. And you know, his heart was one of those things. I mean, even with the medicine today they have, like Dr. Shah was saying, I mean, it's amazing. We talk the EKG's and the things, and how everything is so advanced. I've seen -- they moved on to even sonograms now, where they would take a sonogram of your heart to get every valve and every angle. And that's what we did with my son, they have what's called the 4D sonogram, which shows every vessel and chamber, and it's was an amazing thing. He's got a healthy heart, thank God.

KING: You have children, Kate?

JACKSON: I have adopted son, Taylor.

KING: Are my children more likely to have heart disease?

SHAH: Well, it depends. It depends on the lifestyle. I think, what we talk about -- we say genetics loads the gun, but lifestyle pulls the trigger. And that's the way to think about it. You can inherit a tendency to have heart disease, but you can keep that under check by adopting a healthy lifestyle.

KING: And will we some day, Dr. Douglas, splice that gene, so if my son has the gene, if it is a gene, you could take it away? DOUGLAS: It may be that gene therapy is helpful. It may be that stem cell therapy, I know, very, very actively going on in California, conversations about stem cell therapy. But some how we use the body itself to deliver new genes or to deliver fresh cells to the heart muscle or to the blood vessels themselves to refresh and restore and prevent disease from happening.

KING: I salute you all. I thank you for coming forward to discuss your own situations, and the doctors who help us all. Just a quick reminder. First, I want to thank the College of Cardiology, The American College of Cardiology for that award that I got yesterday morning in Orlando. The presidential citation.

PANEL TOGETHER: Congratulations, Larry.

KING: We pre-taped this show, so I'm hip saying yesterday.

And this Friday night will be the Larry King, Annual Larry King Gala at the Ritz Carlton Hotel in Washington. And we'll have Tim McGraw and Martin Short entertaining, all the money goes to the Larry King Cardiac Foundation. You want more information on that, it's

We thank Kate Jackson, Phyllis Diller, Brian Littrell, and Dr. P.K. Shah and Duke University's, Dr. Pamela Douglas. I'll be back in a minute to tell you about tomorrow night, don't go away.


KING: Tomorrow night on LARRY KING LIVE, Melanie Bloom will be with us. Her husband was the late David Bloom of NBC News, who died of an aneurysm suffered from sitting in a cramp situation on a tank in Iraq.

David Bloom's widow, Melanie Bloom tomorrow night on LARRY KING LIVE.

Thanks to our panel. Thanks for joining us. Aaron Brown and "NEWSNIGHT" is next. Good night.


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