After Trump’s MRI claim, his doctor’s memo offers little clarity

The White House released a letter from President Trump’s doctor on Monday about the results of “advanced imaging tests.” In the statement from Dr. Sean P. Barbabella said tests of his cardiovascular system and abdominal region showed the president “remains in excellent general health.”

Some medical experts said it was unclear what tests doctors did, why they were done or what the results meant. And they said that under normal medical circumstances, a person without symptoms would not have imaging tests done as part of a routine medical exam.

Mr. Trump, the oldest president ever to take office, underwent an MRI scan in October as part of a biannual physical exam. His annual physical exam took place in April.

On Sunday, Gov. Tim Walz of Minnesota, during an appearance on “Meet the Press” on NBC News, called on the president to release the results after Mr. Trump questioned Mr. Walz’s intelligence information. 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 MRI.” Then he said it wasn’t a scan of his brain.

In dr. But Barbabella’s memo did not state that Mr. Trump had undergone an MRI scan, which uses a magnetic field to create images of soft tissues that are not visible on X-rays. Instead, the memo describes “advanced imaging” that was supposedly performed “because men in his age group benefit from a thorough examination of cardiovascular and abdominal health.”

The imaging was part of Mr. Trump’s “comprehensive executive physical exam,” Dr. Barbabella, referring to a detailed medical exam often offered to executives. Such examinations may include tests that are not normally performed when there are no symptoms of illness.

The memo said Mr. Trump’s cardiovascular imaging was “completely normal” and there were no signs that his arteries were narrowed. His “cardiovascular system demonstrates excellent health,” the statement said.

It added that “his abdominal imaging is also completely normal” and that “this level of detailed assessment is standard for a senior physician of President Trump’s age and confirms that he remains in excellent general health.”

Dr. Ron Blankstein, a preventative cardiologist at Brigham and Women’s Hospital in Boston, said the imaging could have been part of a routine exam, although it is not recommended for people without symptoms of heart disease.

In April, Dr. Barbabella that Mr. Trump is taking two medications to lower his cholesterol levels.

Dr. Blankstein also emphasized the sentence “no evidence of artery narrowing restricting blood flow.” This suggests, he said, that the president underwent a stress test, which could mean a doctor suspected or wanted to rule out heart disease. He said most standard MRI scans do not show the coronary arteries.

However, there is a special MRI scan called a cardiac stress scan in which patients are given a drug that increases blood flow to the heart and then asked to lie down in an MRI machine for an exam. If the results are abnormal, it may indicate that one or more coronary arteries are narrowed. But, according to Dr. Blankstein, “Although a normal stress test ensures that there is no critical illness that restricts blood flow, it does not rule out the possibility of coronary artery disease.”

“Stress testing is often not necessary in people who have no symptoms or heart disease,” he added.

Dr. Jeffrey A. Linder, chief of general internal medicine at Northwestern University Feinberg School of Medicine, said he found the White House statement confusing.

“There is nothing standard about a senior physical exam,” he said. There are no standards and the tests included can vary widely.

And he added: “There is no medical specialty that recommends that an otherwise asymptomatic person have imaging.”

“There’s a reason we don’t test everyone for everything all the time,” Dr. Linder. There’s a much greater chance, he said, that the test would falsely indicate a problem, leading to additional testing being done without success. Instead of finding a problem, this could lead to useless treatments.

“There is real harm,” said Dr. Linder.