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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.


Heart surgery is major surgery, even when it’s a minimally-invasive procedure.  After such a major surgery, a person will certainly need lots of rest and relaxation to recover properly.  Although you know your heart was just repaired, it can be hard to exercise patience. Who doesn’t want to get back to their normal routine as soon as possible? Even though you asked the doctor endless post-op questions prior to surgery, you still begin to wonder when you’ll be able to return to your normal daily activities.

Recovery can be hard both physically and mentally.  Your recovery is unique because you are a unique individual. Every patient heals differently and at a different rate.

For the first week post op, you most likely will be in the hospital. You will spend one to two days in the ICU and then be moved to a regular hospital room for the remainder of the week. During your hospital stay you will be walking regularly and gradually increasing physical activity, so you will be able to walk and go up and down stairs before you head home.

Before sending you home, the doctor will give you recovery instructions, such as watching for any signs of infection, incision care, pain management, and post-op side effects. You will still be sore, but may no longer be on pain meds. The doctor will determine how much physical activity you can do, and will encourage lots of rest throughout the day. The doctor may recommend cardiac rehabilitation, as well as permanent lifestyle changes when it comes to diet, physical activities, tobacco usage, and stress management to promote healing and recovery. If something hurts, stop doing it. Focus on performing activities that don’t hurt you.

Around the fourth or fifth week post-op, you will be getting close to being back to your normal activities. You can be back to work, can travel and celebrate a holiday without feeling awful. Although you are still not 100%, you will feel significantly better now.

Looking for a cardiac surgeon to perform your heart valve surgery? This is Dr. Peter Mikhail’s specialty. Dr. Mikhail is a cardiac surgeon based in New Port Richey, FL, and treats patients in Tampa and Clearwater. He is considered one of the foremost authorities and specialists in mitral valve surgery and TAVR. To book a consult, click here or call 727-312-4844.


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.


Blood pressure and heart health go hand in hand. Your blood pressure reading reflects two numbers, systolic pressure and diastolic pressure. Your systolic pressure measures the pressure of the blood against your artery walls when the heart pumps blood out during a heartbeat, while your diastolic pressure measures this pressure in-between heartbeats when your heart is full of blood. Ideally, your blood pressure should read below 120/80. One in three American adults suffer from high blood pressure.  One thing you can do to keep your blood pressure in check is to eat a balanced diet. Certain foods are known to increase your blood pressure.  We suggest you avoid the following foods or limit them in your diet to keep your blood pressure in a good range:

  1. Soda/sweetened beverages – Sugar-loaded drinks can quickly lead to weight gain; excessive weight on the body can raise a person’s blood pressure.
  2. Processed meats and other foods – Deli meats like turkey or ham are loaded with sodium, which can raise a person’s blood pressure. Lots of packaged foods contain high amounts of sodium, e.g. canned soup, frozen meals, tomato sauces, canned vegetables and bread. These foods have a lot of sodium, because this ingredient is used to preserve the foods.
  3. Baked goods – Cakes, doughnuts, muffins, cupcakes, cookies, pies and more are loaded with sugar, but also contain a lot of saturated and trans fats. Both these “bad” fats are known to increase blood pressure.
  4. Candy – When you eat a piece of candy, you’re basically consuming empty calories and a lot of sugar; candy can spike your sugar levels and can lead to weight gain.
  5. Alcohol – Excessive use of alcohol can lead to weight gain and dehydration both of which can lead to an increase in blood pressure.

Each day, you should aim to keep your sodium intake to less than 2,300 milligrams; sugar should be limited to 37.5 grams per day for men and 25 grams per day for women. It’s best to avoid or limit the above foods and opt for water, 100 percent fruit juices, fresh meat, fruit, homemade (healthier) desserts, nuts, legumes, vegetables, and whole grains.

If you currently have high blood pressure or heart disease, it’s wise to discuss with your doctor the best meal plan for you. If you suffer from mitral valve disease or aortic valve disease and need surgery, Dr. Peter Mikhail is a cardiac surgeon treating patients in the Tampa, Clearwater and New Port Richey areas of Florida. To book an appointment, click here or call 727-312-4844.



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.


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.


Whether you have suffered a heart attack or stroke, or have been told by your doctor that you are at an increased risk of heart issues, chances are you have been looking seriously into ways to change your lifestyle. Nothing prompts healthy lifestyle changes like a scare, but we don’t have to wait until we have a heart attack to find out we are at high risk before we take our lives into our own proverbial hands and make some healthy changes for the better.

For most of us, diet and exercise are the two areas where lifestyle and personal change can make a significant difference in our heart health and resulting risk factors. While it might be nice to think that medication alone is all that we need, effort on our part to make better, more healthy choices, is part and parcel to being healthy and to reduce the risk for issues or recurring issues.

Diet is an area where almost all of us fail to meet the recommended goals. For whatever reason, most of us eat a diet rich in fattening, oversized portions of convenience foods that are high in calories and low in nutrition. While we do not have to resort to a life without cheeseburgers, we do have to make changes in what, how much, and how often we eat.

There are some simple rules of thumb for keeping your diet under control and changing your diet in more heart-healthy ways. First and foremost, watch the portion sizes. Most of us are shocked when we look a bit deeper and find out just how small a serving size truly is compared with the amount we serve ourselves. Using smaller plates gives you the illusion of eating more and can really help with portion control. Secondly, watch out for liquid calories. A lot of people don’t realize just how many calories they consume with their daily coffee drinks, soda, wine, beer, and juice. Switching out some of these sugar-laden drinks for water or unsweetened tea is a great heart-healthy choice.

When it comes to eating more heart healthy, there are some general tips that will make all dietary choices a bit easier. If we are mindful of the portion sizes we are eating and work to reducing the amount of food we eat to healthier levels, we can really reduce the amount of fat, calories, and artery-clogging foods we consume. Also, by making more cognizant beverage choices, we can reduce the amount of unnecessary sugar and calories we consume in liquid form. These small changes will reduce the amount of fat, sugar, and junk in our diet, promoting more healthy choices.

If you’re currently suffering from heart valve disease and considering surgery, contact Dr. Peter Mikhail. Dr. Mikhail is a cardiac surgeon based in New Port Richey, Florida. To book an appointment, click here or call 727-312-4844.


Mobile apps are the “thing” right now, even in the medical industry. You’ve probably heard of food log apps and step tracking apps, but there happens to be many heart-healthy mobile apps out there that heart disease patients can use. Below, we wanted to share some good mobile apps that can help you on your journey of taking control of your health.

Cardiio – This app can monitor your heart rate, as well as determine your level of cardiovascular health and fitness.  Your phone’s camera measures your heartbeat. The app looks at the light reflected off your face to get its reading. This was developed by people at Harvard University and MIT.

Azumio – Azumio is like Cardiio and it can check your pulse. With this app, you place your pointer finger on the camera and your pulse reading will appear on the screen.

Blood Pressure Companion – This app records heart rate and blood pressure. You can take notes in this app and set reminders for you to take your readings. In this app, you’ll be able to track all your readings for yourself and a doctor.

Digifit iCardio –  In this app, you can track your exercise and progress. You can integrate different music apps and social media sites to go along with your workout. You can track your weight, blood pressure, and sleep. You can also connect this with your Fitbit or other heart rate monitor.

Heart Healthy Meal Planner – The Heart Foundation created this app for people to create heart-healthy meal plans. Within the app, you have access to advice on foods to eat, meal ideas, and recipes. There is a heart symbol shown next to choices that are heart healthy.

Do you currently suffer from heart valve disease? If you’re a candidate for surgery, Dr. Peter Mikhail is a cardiac surgeon who specializes in minimally invasive mitral valve surgery, as well as mini-AVR. These procedures require less recovery time than traditional open heart surgery. Dr. Mikhail is based in New Port Richey, Florida. To learn more or to book a consult with the doctor, visit the Mitral Valve Surgery page or call (727) 312-4844.



You’ve probably heard and read a thousand times about the best diets or foods to eat to be heart healthy; however, do you know the foods it’s best for you to avoid? Nutrition is an extremely important aspect to focus on when currently living with heart disease. Food can either act like a medicine or a poison based on your choices. You want to stay as healthy as possible while living with this disease before treatment, during treatment, and after treatment.

When your heart isn’t functioning at its best, it’s best to stay clear of certain foods to remain as healthy as possible.  Below are some foods you should think about limiting or avoiding if you’re currently suffering from heart disease.

Highly Processed/Refined Grains and Carbohydrates

Carbohydrates are great for your body; they supply the body with energy; however, when a carbohydrate is processed or refined, it loses most of its health benefits (fiber, fatty acids, vitamins and minerals). Processed foods usually come with added ingredients like sodium and trans fats. Some examples include: white bread, white rice, instant oatmeal, and some cereals.

Processed/Refined Sugars

Sugar, in moderation, won’t harm you, but if you consume enough of it, it can harm your heart by raising blood pressure and triglycerides. High dosages of sugar can be found in soda, some cereals, candy, baked goods, canned foods, and juice.

Certain Fats

Trans fats and saturated fats are not the “good” kind of fat. These types of fat can raise bad cholesterol and lower good cholesterol and contribute to clogged arteries. Foods known for their high trans fats and saturated fats include: fried food, margarine, doughnuts, biscuits, cakes, and pies.

High Sodium

Your body needs sodium. It helps keep your blood pressure in check, as well as maintain proper fluid levels in the body. If you consume too much sodium, your kidneys cannot process it all so the remaining sodium can elevate your blood pressure. Too much sodium can put a person at risk for heart failure, a heart attack, kidney failure or a stroke. Foods with high sodium include: canned soups, processed meats, fast food, salted nuts, canned vegetables, frozen meals.

Overall, it’s best to practice moderation in all things, especially in your diet if you are currently suffering from heart disease. One slice of pie at the holidays won’t harm you, but it’s best to avoid the above-mentioned foods with your heart in a fragile state.

If you’re in need of a great surgeon to perform mitral valve surgery or mini-AVR, Dr. Peter Mikhail is a cardiac surgeon in New Port Richey, Florida, who specializes in these surgeries. To book a consult or for more information, click here or call 727-312-4844.


If you’ve been diagnosed with heart valve disease, or know someone who has, you’ve probably heard a lot talked about the heart valve flaps. Well, what exactly are heart valve flaps? What do they do?

Heart valve flaps are also referred to as heart valve leaflets.  The heart valve flaps are made up of tissue, and they operate like doors. They open and close to allow blood flow through the heart in one direction. When functioning properly, these flaps close tightly.  The mitral valve has two flaps and the aortic valve has three valve flaps.

When people experience heart valve problems, the flaps are often to blame. If the flaps no longer close tightly, a patient has a good chance of developing heart valve disease. Depending on what’s happening to the flaps and valve, the person can be experiencing a different type of heart valve disease.

For the mitral valve, there are three different ways for the flaps to fail at doing their job. Mitral valve regurgitation/insufficiency is when the flaps do not close tightly, so blood leaks back into the left atrium of the heart.  In mitral valve stenosis, the flaps have thickened or stiffened and may even fuse together. Because of this, there is a narrowing of the valve or a blockage. Lastly, mitral valve prolapse is when both of the valve’s flaps are enlarged or bulging, which keeps them from closing evenly.

With the aortic valve, aortic valve regurgitation occurs then the flaps no longer close properly and blood flows back into the left ventricle of the heart. Aortic valve stenosis is when the flaps have thickened or stiffened and potentially fuse together, which narrows the valve.

If you’re having a problem with the flaps in your mitral valve or aortic valve, you may be a good candidate for mitral valve surgery or mini-AVR. If you’ve been looking for a cardiac surgeon, Dr. Peter Mikhail specializes in mitral valve surgery and mini-AVR. He is based in New Port Richey, Florida. To learn more click the Mitral Valve Surgery or Mini-AVR pages. To book a consult, click here or call 727-312-4844.


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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