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MITRAL VALVE BLOG

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Did you know the mitral valve is made up of five parts? The five parts are the leaflets, the annulus, the chords, the papillary muscles, and the ventricle wall. Together, these parts make up a suspension system for the leaflets to open and close properly. For this article, we will focus on discussing the mitral valve chord (or chordae).

The chordae look like chords and they connect the leaflets to the papillary muscles. These cords are responsible for the end-systolic position of the leaflets. There are marginal (primary) chordae, intermediate (secondary chordae) and basal (tertiary chordate). Marginal chordae function to prevent the prolapse of the margin of the leaflet. Intermediate chordae relieve valvular tissue of excess tension, and help preserve ventricular shape and function. Basal chordae connect the leaflet base and the mitral annulus to the papillary muscles.

The chords can malfunction by rupturing from an infection or prolonged elongation due to a possible collagen disorder. If the mitral chords rupture, they will leak blood, which develops into mitral regurgitation. Mitral regurgitation is a form of mitral valve disease or heart disease. The blood is leaking back into the left atrium of the heart. If left untreated, the heart could become enlarged, heart muscle damage could occur, or the person can develop congestive heart failure. If these chords rupture, a person may experience heart palpitations, shortness of breath, difficulty breathing during exercise, and fatigue as symptoms.

The mitral chords can be repaired by removing the damaged chords and the attached leaflet segments and replacing them with a mitral (annuloplasty) ring. If the mitral valve regurgitation isn’t severe, a patient can be treated with prescription medications.

During a mitral valve chord repair, the surgeon ensures that the blood in the valve will be moving in one direction again. The earlier that mitral valve disease is caught the better a person’s chances are for a full recovery without damage to their heart or lungs.

If you suffer from mitral valve disease, it’s time to talk to a mitral heart valve surgeon about your options. Dr. Peter Mikhail is a mitral valve surgeon who specializes in heart valve surgery. To book a consult, click here or call 727-312-4844. He is based in New Port Richey, Florida, and treats patients in the Tampa and Clearwater areas.


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Your doctor just told you that you have a calcified heart valve. One of your heart valves is stenotic. You potentially may need it repaired, or completely replaced. What does this exactly mean? How is there calcium build up on my valve? What is a stenotic valve? Is surgery the only option?

Upon being diagnosed with a type of heart valve disease, a lot of questions are probably buzzing around in your head – as they should be. Remember, never hold back from asking your doctor questions. You have just been diagnosed with mitral valve stenosis, which can be a very serious condition if left untreated. So, you should feel the need to ask and learn everything about this disease.

For this article, we address heart valve calcification/mitral valve stenosis to give you an overview of this disease. First, mitral valve disease is when the mitral valve (located between the left atrium and left ventricle heart chambers) is no longer working properly. When the valve isn’t functioning properly, the heart is unable to pump enough blood out of the left ventricular chamber to give the body oxygen-filled blood.  There are different types of mitral valve disease, but for this article, we will focus on mitral valve stenosis (obstruction).

Mitral valve stenosis is when the valve’s opening has narrowed and the valve’s flaps have thickened or stiffened; the flaps may have even fused together, which causes the narrowing or blockage of the valve. When this occurs, blood backs up in the left atrium of the heart instead of flowing to the left ventricle.

When the heart valve becomes calcified, there is a large amount of calcium on the valve, and it has been building up for many years. When the valve becomes calcified, the flaps become stiff and the valve narrows and becomes stenotic. How does this happen? Well, there are a few reasons. Some people’s valves begin to calcify just from age and wear and tear of the valves. Some people are born with congenital valve abnormalities. Some people’s lifestyle choices and history (smoking, chronic kidney disease, diabetes, elevated cholesterol) can lead to calcified valves. Some people’s valves become calcified through atherosclerosis, which is a process that causes arterial blockages in different parts of the body.

A person who has severe stenosis and calcification will experience shortness of breath, chest pain and lightheadedness.

With moderate to severe cases, surgery (valve repair or valve replacement) is usually suggested as the best option to fix the valve and eliminate symptoms. Patients can choose with their doctor whether they want a mechanical or biological heart valve. It’s good to note that even if you get your heart valve repaired or replaced, a biological valve can calcify again.

Unfortunately, there Is no known way to truly prevent the valves from calcifying. However, if a person does have a calcified valve, he or she should be under the watch of a cardiologist, to assess if the valve worsens over time. The cardiologist will most likely want to follow up in 6 months to a year. Treatment, such as surgery, will be suggested when deemed necessary.

Are you suffering from valve stenosis or calcification and looking for a surgeon? Dr. Peter Mikhail is a cardiac surgeon who specializes in performing surgeries on mitral and aortic valves. Dr. Mikhail is based in New Port Richey, FL, and treats patients in the Tampa and Clearwater areas. To book a consult, click here or call 727-312-4844.


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Infective endocarditis (also known as IE) is an inflammatory condition that affects the inner lining and valves of the heart. It occurs when bacteria enter the bloodstream and settle on damaged heart tissue, weak or abnormal heart valves, or prosthetic valves.

IE is more prevalent among older Americans and men in particular. It affects an estimated four out of every 100,000 people in the U.S., and the number of reported cases appears to be increasing, according to a 10-year study published by the online journal PLOS ONE.

It’s not uncommon for bacteria to enter the bloodstream during certain surgical, routine medical, or dental procedures, and a healthy immune system will fight off the microscopic invaders. However, if they find their way to the heart, those bacteria can accumulate on a damaged heart valve and grow into a mass known as a “vegetation.”

Symptoms of an acute infection, which can become life threatening in a matter of days, include a sudden high fever, increased heart rate, shortness of breath, and fatigue. A sub-acute, or gradual infection will present itself with a mild fever, elevated heart rate, fatigue, chills and night sweats, and a low red blood cell count.

Individuals with heart disease and existing heart conditions – such as surgically repaired heart valves and congenital heart defects – have a higher risk of developing IE.

Infection in the heart is commonly detected with an echocardiogram.  A blood culture can determine what type of bacteria is present. Treatment typically involves the use of intravenous antibiotics over a four-to-six-week span.

Oftentimes, doctors will prescribe oral antibiotics to patients prior to a dental procedure, minor surgery, or a colonoscopy as a precautionary measure.

Gingivitis is a known cause of infection, so keeping your mouth clean and healthy, and getting regular dental care are two simple ways to prevent IE. The American Heart Association offers wallet cards in English and Spanish for people who require extra protection from infection.

Dr. Peter Mikhail is a cardiac and thoracic surgeon based in New Port Richey, Florida, who treats patients in the Tampa and Clearwater areas. For more information on his practice or to schedule a consultation, visit his mitral valve surgery and AVR site for more information or call 727-312-4844.


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This is a heart condition that affects a very small percentage of the U.S. population, and its symptoms may include irregular heartbeat and chest pain.

Mitral valve prolapse, also known as click-murmur syndrome, Barlow’s syndrome and floppy valve syndrome, occurs when the mitral valve flaps do not close smoothly or evenly as the heart beats; instead, the flaps bulge, or prolapse, upward into the left atrium.

In most cases, it’s harmless and most people aren’t even aware they have it.  However, some cases require treatment; for instance, when a prolapsed valve allows a small amount of blood to leak backward, a heart murmur may occur. For some, MVP is genetic, but for others, it’s caused by other health issues, such as progressively weakening connective tissue.

Health professionals can typically detect a murmur during a routine examination, especially if a patient has experienced heart palpitations (sudden rapid heartbeats), chest discomfort and fatigue. For those without symptoms, physicians may use an echocardiogram or magnetic resonance imaging (MRI) to look for issues.

Mitral valve surgery may be required if symptoms appear to be getting worse, the left ventricle of the heart is enlarged or heart functions are worsening. While mitral valve prolapse rarely becomes a serious health condition, it can cause arrhythmias – when the heart beats too fast or slow – that are potentially life-threatening, according to the American Heart Association.

Physicians typically recommend treating the symptoms of MVP with regular exercise, over-the-counter pain relievers and relaxation/stress reduction activities, while avoiding caffeine and other stimulants. Beta blockers, or medications that slow the heart, may also be used to treat heart palpitations.

Experts recommend that individuals with mitral valve prolapse should see their doctor regularly, and a cardiologist every 2 to 3 years. Those with moderate symptoms should get an echocardiogram every 6 to 12 months.

Dr. Peter Mikhail is a cardiac and thoracic surgeon based in New Port Richey, Florida, and treats patients in the Tampa and Clearwater areas. For more information on his practice or to schedule a consultation, visit the Tiny Scar Valve Surgery contact page or call 727-312-4844. To learn more about this disease, visit Dr. Mikhail’s Mitral Valve Disease page.


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If you have been diagnosed with mitral valve disease, you probably have a list of questions. As you should! Mitral valve disease is one form of heart disease, and it can be a very serious condition. Part of your heart valve isn’t working properly, and it’s you and your doctor’s job to decide what to do next so you can live a healthy and long life.

There are three different types of mitral valve disease: mitral valve regurgitation/insufficiency (leaking), mitral valve stenosis (obstruction), and mitral valve prolapse (bulging).

The type of mitral valve disease you have and the severity of it will determine your doctor’s treatment plan. One treatment option is surgery. But when is it time to repair your mitral valve? Is there a good time? Well, if you have a severe case or a big leak, it’s recommended you get the valve repaired now. If you put off surgery, the damaged valve will begin to cause damage to the heart itself. Valves cannot repair themselves; there is no point in waiting. Studies have shown if you wait for symptoms to become severe before you choose surgery, your chance of experiencing complications after the surgery is higher.

If the valve is severely damaged, a surgeon may not be able to repair the valve and a replacement will have to be done. If your valve disease is life-threatening, a replacement valve will be chosen over a repair.

Treatment isn’t always needed for minor causes of mitral valve disease. Sometimes the doctor will just monitor a patient’s heart over the years to see if the disease is getting progressively worse. The doctor can also prescribe medications to reduce the symptoms that patients are experiencing from the disease, but the medications cannot fix the broken parts of the mitral valve. Patients can take antiarrhythmics, beta blockers, diuretics, and anticoagulants.

The thought of surgery can be terrifying; there may be no “right” time, but you want to fix the problem before it gets worse. Dr. Peter Mikhail performs minimally-invasive mitral valve heart surgery on his patients. He makes a small (2 to 3 inch) incision in the right side of the chest. This is not open-heart surgery. With minimally invasive surgery, recovery is shorter. Surgery can take anywhere from 2 to 4 hours.

If it’s time for you to get your mitral valve repaired or replaced, let Dr. Mikhail look at your heart and determine the best course of action. He is a cardiac and thoracic surgeon who specializes in mitral valve surgery. He treats patients in the New Port Richey, Tampa and Clearwater areas of Florida. To book a consult, click here or call 727-312-4844.  Learn more about this surgery on Dr. Mikhail’s Mitral Valve Surgery page.

 

 


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One in four women dies of heart disease in the United States each year; this means about one woman dies every minute of this disease in this country. A new study from researchers in China is suggesting that breastfeeding may lower a woman’s risk of heart disease and stroke. So not only does the baby reap major benefits from breastfeeding, the mother does, as well.

In this study, researchers analyzed around 300,000 women in China. Women who had breastfed were 8 to 10 percent less likely to develop heart disease and stroke compared to mothers who did not breastfeed. Mothers who breastfed for 2 years or more were found to have an 18 percent less chance of developing heart disease compared to women who did not breastfeed. They saw a mother’s risk of these conditions decreased even further (3 to 4 percent) with every additional 6 months of breastfeeding.

Although this particular study cannot prove for certain that breastfeeding caused these women to have a lower risk, it does show that breastfeeding has benefits for the mother when it comes to her cardiovascular health.  Researchers say this lowered risk of heart disease and stroke may be related to a metabolism “reset” that occurs following the pregnancy.  It is hoped that these findings will help encourage more women to breastfeed.

Beyond cardiovascular health, it has been commonly known due to past studies that mothers who breastfeed can experience a lot of health benefits including weight loss, lowered blood pressure, lowered glucose levels, and lowered cholesterol.

Researchers want to conduct further studies on this subject matter with women in other countries to see if they can confirm these findings.

Currently, the American Academy of Pediatrics recommends women exclusively breastfeed for the baby’s first six months. After six months, mothers can breastfeed until 12 months while introducing foods into the baby’s daily diet.

Whether you have breastfed or not, as a woman you should pay close attention to your heart health. If you are currently suffering from heart disease and are looking for a cardiac surgeon, Dr. Peter Mikhail specializes in mitral valve surgery and aortic valve surgery in the Tampa, Clearwater, and New Port Richey area. To book an appointment, click here or call 727-312-4844.


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Get up, and get moving! Exercise is essential to heart health. However, you don’t have to be overly athletic or a marathon runner to reap the benefits of exercise. According to the American Heart Association, a person can improve his or her overall cardiovascular health by participating in at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise (or a combination of both) per week. Exercise comes in many different forms, from running and lifting weights to Zumba class and walking. For this article, we focus on the benefits from one particular type of exercise, Yoga.

Yes, yoga. This form of exercise is much more than a bunch of funny-looking body positions. People have been practicing yoga for more than 5,000 years to help rejuvenate the body and help themselves live a longer life. Yoga has been shown to have numerous benefits including helping reduce stress and bring clarity and peace to a person’s mind. Recently, a new study published in the European Journal of Preventative Cardiology said that yoga may help lower a person’s risk for heart disease in the same way as walking or another conventional exercise.

In this study, people of all ages and health conditions saw improvements in their health while participating in yoga. These people lost weight, lowered their blood pressure, and lowered their LDL (“bad”) cholesterol levels.

Yoga is physical but it also involves a lot of breathing exercises and meditation. These activities can all have positive effects on the heart and body.  Yoga’s impact on muscles and the mind can help control blood sugar, lower blood pressure, and calm the nervous system, which can reduce stress in the body.  Yoga can also help increase a person’s aerobic capacity, and has also been known to help people with atrial fibrillation have fewer episodes.

Yoga classes are available for people of all experience levels. If you have a health condition or aren’t in great shape, a beginner class is a great way to learn all the moves in a slow, controlled way that isn’t intimidating.  Hatha yoga is good for beginners, while Vinyasa yoga is better for those individuals who are more experienced and physically fit. Bikram yoga or Hot yoga, which is yoga in a room with a temperature of more than 105 degrees, is not recommended for people with heart conditions like heart disease.

If you currently have heart disease, talk to your doctor about taking a yoga class. If you’re a candidate for heart valve surgery, Dr. Peter Mikhail performs mitral valve surgery and aortic valve surgery in the cities of Tampa, Clearwater, and New Port Richey of Florida. To book a consult, click here or call 727-312-4844.

 


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During your annual physical, a doctor will listen to your heart with a stethoscope. If the doctor hears anything troubling or odd, he or she will recommend that you have an echocardiogram done on your heart. What is an echocardiogram? An echocardiogram (echo) will show doctors the size, structures, and movements of the parts within your heart. Through this test, a doctor will be able to determine several things, including: the size of your heart, the state of your heart muscles, heart valve problems, problems with your heart’s structure, and signs of blood clots or tumors.

During an echo, a technician will place three electrodes which are attached to an electrocardiograph monitor (ECG or EKG) on your chest. You will be asked to lay down on your left side. He or she will place a wand (with gel on the end) on your chest; the wand is a sound-wave transducer. You may have to change positions a few times during the test, so several areas of your heart will be photographed. Echos are safe and you should feel no discomfort.

An echo lasts for about 40 minutes; you can return to work or other daily activities immediately following. You can eat, drink, and take any medications normally before this test.

There are several different types of echocardiograms and your doctor will determine which one is right for you. Here are brief descriptions of the types of echocardiograms:

Transthoracic echocardiogram – This is the basic echo and is like an x-ray (minus the radiation).
Transesophageal echocardiogram – In this echo, the transducer is inserted down the throat into the esophagus, because the esophagus is close to the heart.
Stress echocardiogram – This echo is taken while the person exercises on a treadmill or stationary bike.
Dobutamine stress echocardiogram – This is a stress echo but without the exercise; the stress is obtained through a drug that makes the body think its exercising.
Intravascular ultrasound – This ultrasound is performed during cardiac catheterization, and the transducer is threaded into the heart blood vessels through a catheter in the groin.

If you’ve had an echo or other stress test, this can help the doctor determine if you are currently suffering from heart valve disease. If you found out you have mitral valve disease or aortic valve disease and need surgery, Dr. Peter Mikhail is an experienced cardiac surgeon who specializes in mitral valve surgery and mini-AVR. To book an appointment, click here or call 727-312-4844.


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Have a sweet tooth? Cupcakes. Chocolate. Ice cream. These sweet treats are certainly delicious, but they’re best eaten in moderation. Sugar is the main ingredient that makes these foods extra tasty. Unfortunately, too much of this ingredient is harmful to our bodies, including our heart.

According to a study published in JAMA Internal Medicine in 2014, a diet high in sugar can raise a person’s risk of dying of heart disease. Even if your weight is in a normal range, you can still be at a higher risk because of your sugar-heavy diet.  In this study, people who consumed 17 to 21 percent of their calories from this ingredient had a 38 percent higher chance of dying from heart disease compared to people who only had 8 percent of their calories coming from added sugar. The more sugar a person consumes, the higher the odds are for him or her to die from heart disease.

Most adults in America consume around 22 teaspoons of added sugar in their daily diet, which is well over the recommended amount. According to the American Heart Association, most women should consume no more than 6 teaspoons of sugar per day, and most men should consume no more than 9 teaspoons of sugar per day.

It’s easy to consume excess sugar in today’s world. Much of the packaged food out there is processed and made with added sugars. Some foods known for their high sugar count include: soft drinks, candy, cakes, cookies, donuts, bagels, fruit drinks, waffles, cereals, sports drinks, ice cream, sweetened yogurt, pies, pastries, and more.

When people consume too much added sugar, they also risk gaining weight, raising their blood pressure, and developing Type 2 diabetes. These high-sugar foods are usually devoid of quality vitamins and minerals, as well.

It’s OK to have these foods in moderation, but for daily sweet cravings opt for fruit instead.

If you currently have heart disease and are looking for a cardiac surgeon, Dr. Peter Mikhail performs mitral valve surgery and aortic valve surgery in the cities of Tampa, Clearwater and New Port Richey in Florida. To book an appointment, click here or call 727-312-4844.


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In America, heart disease is the leading cause of death for both men and women. Because of this startling fact, we want to share some statistics and facts about heart disease with you so you can be better informed on this serious condition.

  • One in four deaths in America is from heart disease. This means around 715,000 people die each year from this disease. In 2011, 787,000 people died from this condition.
  • The most common type of heart disease is coronary heart disease (CHD); CHD kills more than 370,000 people each year.
  • Around 735,000 Americans each year have a heart attack. In the United States, someone has a heart attack every 42 seconds.
  • Someone in America dies every minute from something related to heart disease.
  • High blood pressure, high cholesterol, and smoking are the top three key risk factors that can lead to heart disease.
  • Obesity, excess weight, excessive use of alcohol, poor diet, diabetes, and inactivity are also risk factors of heart disease.
  • Heart disease costs America around $207 billion every year.
  • Even if you don’t have any symptoms, you can still be at risk and/or have heart disease.
  • By the year 2030, around 23.6 billion will have died from a type of heart disease around the world.
  • 80 percent of heart attacks and strokes can be avoided by not smoking, being active, eating healthy, and maintaining healthy blood pressure and sugar levels.
  • Cardiovascular diseases kill more people than all forms of cancer combined.
  • In the last 30 years, more women have died from heart disease than men.
  • 15 percent of people who have a heart attack will die from the episode.
  • France, Australia, Switzerland, Japan and Israel have the lowest rates of heart disease deaths while Russia, Bulgaria, Romania, Hungary, and Argentina have the highest rates.
  • In the USA, states that have the highest rate of heart disease deaths include: Oklahoma, Louisiana, Mississippi, Alabama, Arkansas, Missouri, Tennessee, Kentucky, West Virginia, Maryland, Ohio and Michigan.

If you currently suffer from heart disease or have a high risk of developing it, it’s best to talk to your doctor about the best treatment plan for you. If you’re in need of a cardiac surgeon, Dr. Peter Mikhail performs mitral valve surgery and aortic valve surgery in the Tampa, Clearwater, and New Port Richey areas in Florida. To book a consult, click here or call 727-312-4844.


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Dr. Peter Mikhail is a thoracic and cardiac surgeon in Tampa, Clearwater, and New Port Richey, Florida. Dr. Mikhail is Board Certified by the American Board of Surgery, The American Board of Thoracic Surgery and The Royal College of Physicians and Surgeons of Canada.

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