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In July 1944, a president was preparing to run for an unprecedented fourth term. At the Democratic convention, though Henry A. Wallace was a popular vice president and had big backing, he was switched out for a little-known (but less radical) senator from Missouri. 

This was because the party leaders knew the president was in very poor health, with uncontrolled blood pressure and heart failure, and they feared (correctly) that he might not survive far into the next term. 

In retrospect, the American public had a right to know that they were voting for a very sick man, but it was hidden from them and Franklin Delano Roosevelt was re-elected and soon succeeded by Vice President Harry S. Truman. 

The rest, as they say, is history.

PENNSYLVANIA SENATE CANDIDATE FETTERMAN INSISTS HE IS 'SIT TO SERVE'

Pennsylvania Lt. Gov. John Fetterman is 53 and is running for U.S. senator in one of the most highly contested races in the country. 

His health and fitness to serve have become an issue in the election, but it is important to point out that this isn’t the first time a candidate’s health and health transparency have been an issue and it certainly won’t be the last.

According to the American Heart Association, strokes are on the rise among younger people below the age of 50, in part because of a risk from high cholesterol, weight, blood pressure, heart arrhythmias, and diabetes. 

Fetterman sustained a stroke back in May with at least some residual damage to the hearing and processing centers of his brain. 

His public appearances since then including his debate with opponent Dr. Mehmet Oz have brought up legitimate concerns about his comprehension and executive function. Can he really multi-task and make complex decisions? 

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The exact amount of damage or the medical assessment of his condition are not known to the public because although Fetterman has allowed release of doctors’ letters on his condition nevertheless, his full medical records have not been released.

In terms of long-term recovery, though Fetterman’s age is in his favor (53), his underlying cardiac history is not. 

Multiple studies have shown that the long-term survival rate for first time stroke patients varies. Fetterman has described his stroke as being due to atrial fibrillation (irregular heart rhythm) and a blood clot coming from the heart. 

Patients with this type of stroke have a significant risk of stroke recurrence. In fact a 2020 study in the journal "Stroke" showed greater than a 60 percent chance of stroke recurrence or death over five years following a blood clot thrown from the heart. 

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This is very concerning. And a 2022 study in the journal "Stroke" showed a 50% incidence of recurrent stroke within 5 years in patients with associated heart problems. 

Fetterman also reportedly suffers from a cardiomyopathy, a condition where the heart can be ballooned out and involve serious heart failure. His Pittsburgh cardiologist, Dr. Ramesh Chandra, reported in a letter back in June that he first saw Fetterman in 2017 for leg swelling, a "decreased heart pump," and atrial fibrillation. 

He wrote that Fetterman did not see a doctor for the next five years and was non-compliant with medication until the time of his stroke.

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Studies have shown that the 10-year survival rate of a patient with heart failure (even compensated with medication) is around 35%. Of course, a pacemaker and an implantable defibrillator like the ones Fetterman has, as well as medication, do improve outcomes. The great medical and technological advances that we have enjoyed since FDR’s time make it far more likely that a patient will survive and even continue to recover.

We must all admire Fetterman’s personal courage to soldier on but at the same time it is only fair to question his ability to do so especially in such a high stakes arena. No one would expect a surgeon to operate with a broken arm, for example.

I believe the voters of Pennsylvania have every right to know what a candidate’s health status and health risks are. Access to Fetterman’s full health records would help to address these questions. 

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It is not too late for this release to take place and on the eve of such an important election it would in fact send a refreshing message of a candidate with nothing to hide. 

Sadly, I do not expect this to happen.

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