Yeltsin Has Pneumonia, Is Hospitalized

MOSCOW â€”  Russian President Boris N. Yeltsin fell ill with pneumonia and was hospitalized Wednesday in the gravest sign yet that the 65-year-old leader remains in precarious health after quintuple heart bypass surgery two months ago.

The Presidential Press Service issued a terse announcement after 9 p.m. that Yeltsin’s condition had worsened from a case of flu reported over the Russian Orthodox Christmas holiday. It said doctors who examined him in the evening found evidence of pneumonia and decided to confine him to Central Clinical Hospital “to clarify the diagnosis and conduct appropriate treatment.�

Yeltsin returned to the Kremlin only two weeks ago after spending six months in hospitals and rest homes recuperating from a heart attack in late June--his third in less than a year--and surgery to restore adequate blood flow to the damaged organ.

Officials have sought to play down the seriousness of Yeltsin’s condition since he appeared pale and weary in a meeting with visiting German Chancellor Helmut Kohl on Saturday and after he bowed out of a Tuesday government meeting on the pretext of having “a heavy cold.�

The Nov. 5 bypass surgery conducted by renowned Russian surgeon Renat Akchurin, who was advised by American heart pioneer Michael DeBakey, temporarily eased Russian and foreign fears that the leader of this nuclear-armed power might be at risk of dying with no obvious successor in sight.

But the evidence that has come forward this week attesting to Yeltsin’s persistent health woes is likely to destroy that short-lived confidence about Russia’s future and rekindle the bitter power struggle that raged while the leader was indisposed last fall.

“It is difficult to say whether this cold or flu or pneumonia is connected with his post-operational period, but it is clear that his body is weakened after the operation, and any kind of respiratory disease in this case is very undesirable and may take on a pretty heavy form,� said Igor Y. Sigayev, head of the cardiovascular department of the Bakulev Cardiac Research Center, when asked about the news of Yeltsin’s hospitalization.

“This creates additional and highly undesirable pressure on his still-recuperating heart, and although I’m not in a position to estimate the exact danger, I can say that it is dangerous,� said Sigayev, noting that physicians at the cardiac center always advise bypass patients to be especially careful to avoid contracting flu and colds.

Sergei V. Yastrzhembsky, Yeltsin’s spokesman, insisted at a briefing earlier in the day that there was no cause for alarm over the president’s condition and dismissed suggestions that the “heavy cold� might complicate the leader’s recovery from open-heart surgery.

During the Communist era, when information about the leader’s health was a closely guarded secret, Kremlin mouthpieces often blamed long absences on “colds,� causing such phraseology to become a euphemism for life-threatening situations.

The post-Soviet presidential press secretaries have boasted of more openness and honesty about Yeltsin’s condition, but he has spent many months of his 5 1/2 years as head of state in hospitals or in seclusion at government clinics and sanatoriums.

In Houston, cardiac expert DeBakey, noting that he had spoken with Yeltsin’s doctor, continued to downplay the severity of the Russian leader’s illness. He said doctors had detected traces of a pneumonia infection early and were administering antibiotics.

DeBakey told Reuters news service that Yeltsin was chiefly troubled by the flu but was in better shape than before the bypass to deal with this illness because his heart function has significantly improved.

While Yeltsin was rarely seen in the months before his operation, maverick retired Gen. Alexander I. Lebed took center stage to criticize the ailing leader and cast himself as heir apparent. He voiced similar criticisms of Yeltsin on Wednesday.

During Yeltsin’s surgery, Prime Minister Viktor S. Chernomyrdin briefly assumed power, though there was no mention of any such transfer of authority Wednesday.

Under the constitution, Chernomyrdin would become temporary head of state if the president died in office. He would be obliged to call new elections within three months. But Chernomyrdin is believed to be too unpopular and uncharismatic to retain the office. Any early presidential contest would probably pit Lebed against Communist Party chief Gennady A. Zyuganov, the man Yeltsin defeated July 3 to win a second term that should run to 2000.

Yeltsin has been shown on TV only a handful of times since the November surgery and has looked better than before the operation but nevertheless pale and plodding.

Just last week, his office announced an ambitious schedule of foreign travel for the first few months of this year, including a Feb. 4 trip to the Netherlands and a March visit to the United States for a summit with President Clinton. The scheduled one-day journey to The Hague will probably be the first opportunity to gauge the president’s general health.

Yeltsin had been staying at a suburban Moscow country house since the long New Year’s holiday break, appearing in public only for a photo session before his two-hour meeting with Kohl.

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Anatomy of an Illness

Pneumonia is the name for several varieties of lung inflammation causted by infectious organisms. Generally, it is well understood by doctors and easily treated. For Boris Yeltsin, who underwent heart bypass surgery two months ago, it raises additional concerns.

BRONCHOPNEUMONIA

This type starts in bronchioles (airways) and spreads

Usual symptoms: Fever, chills, shortness of breath

Treatments: Antibotics or antifungal drugs.

Outlook: Most sufferers recover completely within two weeks.

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LOBAR PNEUMONIA

In this type, inflammation can affect one more of the lung’s lobes. The area most commonly affected is shown below.

Source: American Medical Assn. Encyclopedia of Medicine