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Plants Not Transplants: Oscar Munoz, Please Help Us

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The good news was announced this week that CEO of United Continental Holdings Inc. Oscar Munoz underwent a heart transplant Jan. 6 at Northwestern University in Chicago and was recovering. The heart transplant follows a sudden and obviously massive heart attack Oct. 15, 2015, just a few weeks after assuming the lead role at United. Although I do not know Mr. Munoz, I wish him well and am sure he is receiving excellent care.

When Mr. Munoz is fully healed I invite him be a force for change in raising the early detection of silent heart disease, and better yet, the prevention of heart disease, to national attention. Although I do not know the details of Mr. Munoz's case, I suspect that a coronary artery calcium scan (CACS) done even a few days before his heart attack would have identified advanced heart artery disease. Although this CT scan, often called the mammogram of the heart, is widely available, takes less than a minute, and costs under $100 in my community, it is rarely ordered by primary care doctors for their patients around age 45-50. This is despite recommendations for using the CACS for those at risk by the American College of Cardiology, the Society for Heart Attack Prevention and Eradication, the National Lipid Association, and in my book "Dead Execs Don't Get Bonuses." The importance of the CACS was highlighted in a recent commentary in a popular cardiology website. In my practice, those with abnormal results on a CACS get intensive education and monitoring of all known factors leading to atherosclerosis. Some are found to have disease so advanced, although silent, to require a heart stent or bypass operation as Mr. Munoz may have needed before Oct. 15.

I also hope that Mr. Munoz will study the science of preventing heart disease and heart attacks. Over and over, six lifestyle steps have been shown to prevent 85 percent of heart attacks. These are not expensive but are not routinely taught or encouraged in corporate settings and include: 1) not smoking, 2) walking 30-40 minutes daily as a minimum, 3) maintaining a slim waistline, 4) sleeping seven hours at night, 5) occasional alcohol intake if not medically contraindicated and finally but most importantly, 6) eating over five servings a day of vegetables and fruits. I would hope Mr. Munoz can be a force for change to initiate programming at United and Continental Airlines to have fresh fruit and vegetables available at all functions and for all employees and eliminate sources of processed meats, sugars and oils. His company would truly fly high with a healthy transformation if this was instituted.

In my three decades of cardiology practice I have seen heart attack therapy evolve from bedrest, to blood clot dissolvers, to emergency balloons and then stents. Now some individuals benefit from heart support devices and even transplants like Mr. Munoz. Was has not changed in those years is that an ounce of prevention and early detection is worth pound of cure, even if it is a lifesaving transplant. Mr. Munoz, please watch the documentaries Forks Over Knives and The Widowmaker Movie while you recover (and my book if you have the time). Join the movement for a world with empty coronary care units and operating rooms.