The White House released a letter from President Trump’s physician on Monday about the results of “advanced imaging tests.” The statement, by Dr. Sean P. Barbabella, said the tests on his cardiovascular system and abdominal region showed the president “remains in excellent overall health.”
Some medical experts said it was unclear what tests doctors conducted, why they were done or what the results mean. And, they said, a person without symptoms would not have imaging tests as part of a routine medical exam under ordinary medical circumstances.
Mr. Trump, the oldest president ever sworn into his office, had M.R.I. scans in October as part of a semiannual physical exam. His annual physical was done in April.
On Sunday, during an appearance on “Meet the Press” on NBC News, Governor Tim Walz of Minnesota called on the president to release the results after Mr. Trump had impugned Mr. Walz’s intelligence. Asked by a reporter on Sunday what part of his body was scanned, Mr. Trump said aboard Air Force One, “I have no idea — it was just an M.R.I.” He then said it was not a scan of his brain.
But Dr. Barbabella’s memo did not specify that Mr. Trump had a M.R.I. scan, which uses a magnetic field to produce images of soft tissues that do not show up on X-rays. Instead, the memo describes “advanced imaging” that it said was carried out “because men in his age group benefit from a thorough evaluation of cardiovascular and abdominal health.”
The imaging was part of Mr. Trump’s “comprehensive executive physical,” Dr. Barbabella explained, referring to a detailed medical exam often offered to executives. Such exams can include tests that are not normally done when people have no symptoms of disease.
The memo said Mr. Trump’s cardiovascular imaging is “perfectly normal” with no signs that his arteries are narrowed. His “cardiovascular system shows excellent health,” the statement said.
It added that, “his abdominal imaging is also perfectly normal,” and said, “this level of detailed assessment is standard for an executive physical at President Trump’s age and confirms that he remains in excellent overall health.”
Dr. Ron Blankstein, a preventive cardiologist at Brigham and Women’s Hospital in Boston, said imaging could have been part of a routine checkup, though it is not recommended for people with no symptoms of heart disease.
In April, Dr. Barbabella said that Mr. Trump takes two medications to lower his cholesterol level.
Dr. Blankstein also highlighted the phrase “no evidence of arterial narrowing limiting blood flow.” It suggests, he said, that the president underwent a stress test, which could mean a doctor suspected or wanted to rule out heart disease. Most standard M.R.I. exams, he said, do not show the coronary arteries.
But there is a specialized M.R.I. scan, known as a cardiac stress exam, in which patients are given a medication that increases blood flow to the heart and then asked to lie in an M.R.I. machine for a scan. If the results are abnormal, that can indicate one or more coronary arteries is narrowed. But, Dr. Blankstein said, “a normal stress test, while reassuring that there is no critical flow limiting disease, does not rule out the possibility of coronary artery disease.”
“Stress tests are often not required in individuals who do not have symptoms” or cardiac disease, he added.
Dr. Jeffrey A. Linder, chief of general internal medicine at Northwestern University’s Feinberg School of Medicine, said he found the White House statement confusing.
“There is nothing standard about an executive physical,” he said. No standards exist and what tests are included can vary widely.
And, he added, “there is no medical specialty that recommends that an otherwise asymptomatic individual get imaging.”
“There is a reason we don’t test everybody for everything all the time,” Dr. Linder said. The chance is much greater, he said, that the test would falsely point to an issue that would lead to rounds of extra testing to no avail. Instead of finding a problem, it could lead to useless treatments.
“There are real harms,” Dr. Linder said.
Gina Kolata reports on diseases and treatments, how treatments are discovered and tested, and how they affect people.
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