In 1992, President Bush's reelection bid began badly when he vomited and collapsed in Japan at a dinner party thrown by the country's prime minister. From then on, the campaign was dogged with mostly unconfirmed rumors of his ill health. It was speculated, for example, that atrial fibrillation medications he took were affecting his mental acuity. What else would explain his pallid and lackluster performance at debates and appearances, particularly compared to the robust physical health and voracious appetite exuded by opponent Bill Clinton? The Bush campaign headquarters vigorously denied every ill health charge but it didn't change the fact that it wasn't only the economy that was ailing -- it was also Bush's physical image. His election results were equally anemic.

So when Dick Cheney was officially announced as George W. Bush's running mate this week, campaign managers went to great lengths to show that Cheney was physically fit. A highly credentialed cardiologist tapped by the Bush family gave the 59-year-old former defense secretary a clean bill of health -- despite a medical history that includes three previous heart attacks and quadruple bypass surgery more than a decade ago.

The basis for this medical pronouncement seems thin at best. Denton Cooley, chief surgeon at the Texas Heart Institute, based his assessment not on an actual examination of Cheney but on a review of his records and a telephone call to his cardiologist, Jonathan Reiner, whom Cooley reported as saying: "Mr. Cheney is in good health with normal cardiac function."

Reiner then gently countered that no one who has had three heart attacks has completely "normal" cardiac function -- that is, the three heart attacks had left Cheney with permanent damage to the heart.

So how sick is Cheney? It's confusing, as Wednesday's New York Times story on the subject attests. The lead cheerily announces that Cheney is in "excellent health," then goes on to state that he takes "many drugs for heart disease and other medical conditions." The laundry list that follows is pretty daunting: besides heart disease, the doctor had him treated for a number of other ailments (including many for which he continues to take medication), from gout to skin cancer to a potentially fatal allergic reaction to pomegranates to metabolic disorders.

Of course, it's quite possible that Cheney could be relatively unaffected by his past heart troubles. Certainly quantum leaps in the treatment of heart disease, the nation's No. 1 killer, have dramatically improved the quality of life of those diagnosed, even after surgery. A greater understanding of the disease and what signifies its recurrence also allows doctors to more closely monitor a person's condition.

Controlling the diet, regular exercise, quitting smoking and taking medication -- all things that Cheney practices, according to his doctor -- can change the lives of heart disease sufferers profoundly, doctors say.

"The perception is that people who suffer heart disease are not capable of fully functioning," says Dr. Lynn Smaha, a cardiologist and the past president of the American Heart Association. "But many people go on to live fully productive lives after surgery."

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