Former President Clinton realizes the warning signs of heart disease began long before he had quadruple heart bypass surgery, and he has one message for the public: Don't ignore your body.
"The number one thing I would say to people is if you've got a family history, you gotta be tested, tested, tested," Clinton told ABC News' Diane Sawyer in an exclusive interview that aired today on "Good Morning America."
"You should bend over backwards to make sure you get the medicine that you need and watch your diet. And the only signals are not, you know, where your chest is hurting so bad you can hardly stand up, and you're on the verge of a heart attack. … It may be sustained shortness of breath or inability to do things you used to do. You just can't assume it's the aging process."
"I just missed it [the warning signs]," Clinton continued. "That was my fault. I don't blame my doctors or anybody else. … I was insufficiently vigilant."
Seven weeks after his Sept. 6 surgery, Clinton joined Democratic presidential hopeful John Kerry on the last full week of his campaign before the Nov. 2 election. The so-called "Comeback Kid" -- noticeably thinner but exuberant -- appeared at Kerry rallies in Pennsylvania and Florida on Monday and plans to campaign for the Massachusetts senator this weekend in Nevada, New Mexico and his home state of Arkansas.
Doctors said Clinton had nearly 100 percent blockage in some of his arteries when he underwent surgery and had narrowly avoided having a major heart attack. Clinton said he believes he began experiencing the symptoms of heart disease shortly after he left the White House -- even though he was exercising and, he believed, in good physical condition.
"I worked out with a trainer. I was in the best shape of my life," Clinton said. "Still, when I'd go out for a run, after a mile I'd have to stop and walk 100 yards or 200 yards to get my breath. And then I could run again."
Clinton said he continued to feel periodic shortness of breath and tightness in his chest after exercising into the spring of 2004. But he always attributed them to other factors.
"I had several instances where my chest felt tight when I was exercising," he said. "And because I could, you know, slow down and then resume that level without tightness returning, I just assumed it was because I was exhausted, and I was out of shape."
However, this past summer, Clinton noticed he was have increasing difficulty with physical activity. Eventually, he began to feel shortness of breath and tightness in his chest when he was not physically active. Clinton said he felt severe tightness in his chest after a book tour on Aug. 31 in New Orleans.
"Each time he exercised, he was feeling this," said Dr. Allan Schwartz, Clinton's cardiologist. "And the symptoms were gradually getting worse, occurring at a lower and lower threshold. … The episode that landed him in the hospital was an episode of symptoms at rest lasting 20 to 30 minutes."
Clinton's symptoms did not show up in a stress test, which lasts between 12 and 15 minutes. And since his cholesterol levels fluctuated, he was reassured into stopping taking his cholesterol medication, Zocor.
But Clinton does not blame his doctors for taking him off Zocor.
"To be fair to them, they used the latest standards for what [bad] cholesterol was," he said. "And my cholesterol was below that. And it's much lower now."