Although the President is almost always with someone, this happened at about 5:35 p.m. when Bush was on his own watching a Baltimore Ravens-Miami Dolphins playoff football game. He was in a bedroom on the second floor of the White House, seated on a couch. He passed out for a few seconds, then woke up and as soon as he regained consciousness, he called the White House medical office and talked to a nurse on duty at the White House. She summoned White House physician Dr. Richard Tubb, and they gave Bush an initial evaluation.
When the incident was reported, the President quipped "My mother always said when you're eating pretzels, chew before you swallow."
According to Dr. Tubb, Bush had been feeling unwell for a couple of days, and he lost consciousness for a short time when his heart rate slowed after he choked on the salty snack. He cut his face and bruised his lip when he fell to the floor. Bush said that he only realized what had happened when he looked up to see his two dogs, Barney and Spot, looking down at him. "I hit the deck and woke up and there were Barney and Spot showing a lot of concern," he said. The doctor said it is possible that the pretzel stimulated the vagus nerve, which runs up the neck and regulates the heart rate. Its stimulation can cause the pulse to drop.
After being assisted by th medical staff, Bush went to the elevator and took it to the first floor where he underwent neurological, cardiopulmonary and other tests. His blood pressure, pulse, blood sugar and blood oxygenation were all checked. All tests were normal. Dr. Tubb urged his patient to go to bed early. After the event, Bush had soup and salad with his wife, who had been on the phone in a nearby room during her husband's blackout.
Dr. Tubb later said "He fainted due to a temporary decrease in heart rate brought on by swallowing a pretzel," adding that the president had complained of feeling "a little off his game" in recent days. "He said it [the pretzel] didn't seem to go down right, the next thing he knew he was on the floor."
At the time President Bush was 55. He ran regularly and reportedly had a lower than normal resting pulse rate, which doctors attributed to his high level of fitness. According to Dr Tubb, this made him more prone to fainting when the pretzel stimulated a nerve when it got caught in his throat.
Dr. Adrian Petretska, a neurologist at George Washington University Hospital, said: "It could happen to anybody. It is a typical reaction of the body of a patient who has something stuck in the throat."
Bush has a bruise on his lower lip and a scrape on his left cheek bone about the size of a half-dollar. The President said that he believed his head either hit the floor or a table next to the couch, and that his glasses cut his face, Fleischer said.
The incident happened almost exactly 10 years after President Bush's father, President George H. W. Bush famously collapsed and vomited as he was seated next to Japanese Prime Minister Kiichi Miyazawa during a state banquet in Tokyo.