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MITRAL VALVE BLOG

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Marijuana is no longer illegal everywhere, as many states have legalized its usage for both medicinal and recreational purposes. It is a commonly used drug. In recent years, more reports have emerged about marijuana’s cardiovascular side effects. These side effects may be uncommon, but they can still be potentially harmful.

Some studies and theories state that marijuana slows down the blood flow in the coronary arteries. One study showed a patient passing out after marijuana usage; this patient developed dangerous heart rhythms from the reduction of blood flow in the coronary arteries. After the marijuana was out of the system, the flow reverted to normal, as well as the heart rhythm. In another case, the slow coronary blood flow due to marijuana usage led to a major heart attack.

The body’s heart rate and blood pressure increase within minutes of using marijuana despite people saying the drug has relaxing effects. Statistically, people who use marijuana are more likely to use other illegal drugs, more likely to smoke, and have a poorer diet, which are all risk factors for heart disease.

One of the more common side effects of marijuana usage reported is an irregular heart beat (atrial fibrillation). Usually, the afib occurred right after inhaling. Often, afib can occur without the person even knowing. Usually, there was no recurrence once the marijuana usage stopped.

In one study, the risk of heart attack increased 5 times the average after one hour after using the drug. Other reports have found this same finding.
It can be hard to target marijuana as the sole reason a person is experiencing heart problems, because often the person is also a smoker or uses other drugs, so to put the blame solely on marijuana would be false. As more studies and reports study marijuana’s relation to heart disease and other heart problems, we will be able to see if there is a correlation, and if marijuana causes harmful side effects to the heart. Despite there not being many studies proving one way or another if the drug’s effect on the heart is bad, it is still good to keep in mind that the drug may have some harmful effects.

If you experience afib or any other issues with your heart, it’s time to get them checked out. If you suffer from heart valve disease and need surgery to repair or replace a valve, it’s time to talk to a heart valve surgeon about your options. Dr. Peter Mikhail is a heart valve surgeon who performs mitral valve surgery, TAVR and mini-AVR. 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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February has just past, and whether you’re in a relationship or not, you may have had your share of Valentine’s Day candies. Who can resist the heart-shaped chocolates in the store? Since you may have consumed an excess amount of chocolate, you may be wondering, “Is chocolate even good for me? And my heart?” The good news: it is! However, you should be eating it in moderation. Too much of anything can be bad for the body.

Chocolate has positive benefits on the body. How? It can help promote better blood flow, lower blood pressure and improve some cardiac conditions. A few years ago, researchers from Boston to Birmingham conducted a trial and found that chocolate helps the heart because of the flavonoids it contains. Studies have showed people with higher weekly consumption of chocolate had the lowest risk for heart disease, but if you replaced that chocolate with candies (non-chocolate) they could actually double their heart disease risk.

Flavonoids are a nutritional subset of polyphenols, which help lower incidences of coronary heart disease and stroke. The highest flavonoid amount is found in dark chocolate.

According to the dean of the Friedman School of Nutrition Science and Policy at Tufts University, polyphenols help to improve the health of the blood vessels.  In one study, people who consumed 16-100 grams of chocolate per day benefitted the most from consumption.

Dark chocolate isn’t the answer to all your heart problems though! Eating chocolate all day will not make you the healthiest person. You still need to consume a heart-healthy diet full of protein, healthy fats, whole grains, fruits, and vegetables.

So, enjoy a piece or two of that left-over Valentine’s candy!

If you have a history of heart disease in your family or currently suffer from heart disease, it’s time to talk to your doctor about the best heart-healthy diet for your specific needs.  If you suffer from heart disease and potentially need surgery, it’s time to talk to a heart valve surgeon. Dr. Peter Mikhail is a heart valve surgeon who specializes in mitral valve surgery and TAVR. 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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You just had heart valve surgery. Be proud of yourself and your body for undergoing some major surgery to enable you to lead a healthier, longer life. But, now what? What do you do after heart valve surgery? How do you take care of your heart? We want to share some basic things you will need to do to stay healthy after heart valve surgery.

Right after surgery, you will be told to walk regularly, perform breathing exercises and gradually increase activity. Your doctor will give you recovery instructions, such as to watch for any signs of infection, incision care, pain management, and post-op side effects. Your doctor will determine when you can return to daily activities. Cardiac rehabilitation (to help improve health and help with recovery) may be recommended by your doctor, as well as permanent lifestyle changes when it comes to diet, physical activities, tobacco usage, and stress management.

If you had mitral valve surgery recently or even a few years back, you may be wondering “How do I take care of myself going forward?” If your repair went well, your doctor will check up on you periodically. If he or she doesn’t hear anything irregular through a stethoscope, no extra testing will be needed, especially if you feel fine and have no alarming symptoms. If you’ve had an artificial valve put in, your doctor will pay attention to its wear and tear and know when it needs to be replaced again.

If you’ve had a good repair by a good surgeon, your heart (and new valves) should be long-lasting. There is no need to repeat unnecessary tests if you feel fine and the doctor hears or sees no problem during a physical exam.

Your doctor will continue to recommend that you eat well, watch salt intake, watch your weight, eat lots of fruits and vegetables, and aim to do some form of exercise regularly.

If you stick to healthy diet and exercise choices and get checked up once or twice a year by your doctor, you will continue to keep your heart happy and healthy.

If you suffer from heart disease, it’s time to talk to a heart valve surgeon about your options. If you’re looking for a great heart valve surgeon, Dr. Peter Mikhail specializes in mitral valve surgery and TAVR. 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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Survival and mortality rates isn’t a subject anyone is excited to talk about, but we must talk about it when it comes to having heart valve disease and surgery.

There are potential risks when undergoing any surgery, even a minimally-invasive surgery. When it comes to heart valve surgery, there isn’t a set percentage, per se, for the survival or mortality rates, because it’s very situational; the numbers depend on the patients. For example, a healthy 50-year-old who needs to undergo heart valve surgery might have a 0.5 percent risk of death (1 out of 200), but an 85-year-old patient with other health problems could have a 10 to 15 percent (or more) mortality rate. However, to give you a ballpark average, according to The Society of Thoracic Surgeons the mortality rate for heart valve surgery is about 1.7 percent. In some clinics, this percentage is even lower.

If you’re having heart valve issues, an experienced heart valve surgeon, like Dr. Peter Mikhail, will meet with you, give you an exam and look at your history to determine if you are a candidate for mitral valve surgery, mini-AVR or TAVR. Even if you are a good candidate, the doctor will make you aware of the risks that come along with the procedure. If the procedure is too risky for you, the doctor will not suggest surgery.

If a person with severe heart disease is a candidate for surgery, then surgery is highly recommended. Without surgery, the patient could risk an early death. For example, a person who has severe aortic stenosis only has an average 50 percent survival rate after 2 years with the severe disease and only 20 percent after five years if he or she goes without surgery.

Each year, more than 700,000 heart surgeries take place globally, and more than 250,000 of these surgeries are valve repairs and replacements. With such a large number of people undergoing this surgery you don’t have to worry about having some new, untested surgical procedure.

If you’re hesitant about having heart valve surgery, we understand. You want to look for a surgeon who will answer all your questions, and who is extremely experienced in this type of surgery. Dr. Peter Mikhail, who is based in New Port Richey, Florida, is one of the foremost authorities and specialists in mitral valve surgery, mini-AVR and TAVR. To book a consultation, click here or call his office at 727-312-4844.


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Heart valve surgery is a life-saving procedure. Today there are minimally-invasive mitral valve and aortic valve surgeries, so the patient has a shorter recovery period. However, the possibility of re-operations on the heart valve does occur. Why? Leaking can occur. Also, the valves are not everlasting and are subject to wear and tear over the years.

A mechanical valve can last inside a person’s body for more than 20 years. The valves are made from pyrolytic carbon. Most likely, you will need valve surgery only once, and never have to replace the valve. That is, unless you get this surgery done at a younger age. A biological tissue valve often has to be replaced because it lasts only 10 to 18 years. A patient’s life expectancy is strongly considered with this valve, since he or she will most likely need another surgery when the first tissue valve degenerates. This type of valve is recommended for patients 60 years old or older.

Nothing is perfect; sometimes, patients have leakage again just a few months after their surgery while others may never have a leak. Some patients will need a repair while others will need a whole new replacement. If a patient leaks soon after the surgery, this is called an “early failure.” How the doctor will fix this new leak will depend on what type of valve disease the person had to begin with. For example, mitral valve prolapse is almost always re-repairable. The doctor will examine you and do a workup to see if the time is right to do a re-operation. Mitral valves are living pieces of tissue, so the surgeon aims to preserve them whenever possible.

Re-operations have become safer in the last decade. You want to make sure you’re working with a heart valve surgeon who is experienced in re-operations. Re-repairs require extensive experience. It is a “super” specialty. Re-operations are challenging because after the first operation, the heart and tissues healed with scarring and tissues are stuck together, so the risks of injury to the heart and blood vessels when getting into the chest is higher. Also, scarring makes re-operating on the valves more challenging.

Re-repairs are done on:

  • Patients who had a previous heart operation unrelated to the heart valves, but now need heart valve surgery.
  • Patients who had a mitral valve repair who developed a new leak in the valve or the valve was unable to be fully corrected in the first operation.
  • Patients who had a valve replacement who now need a new valve replacement, because the previous valve is worn out, not working properly, or is infected.

If you’re looking for a cardiac surgeon to perform your heart valve surgery and discuss valve replacement or repair options, book a consult with Dr. Peter Mikhail who is based in New Port Richey, Florida. Dr. Mikhail is one of the foremost authorities and specialists in mitral valve surgery and he also performs mini-AVR and TAVR. To book a consultation, click here or call his office at 727-312-4844.


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February is American Heart Month! This is a great time to commit to a heart-healthy lifestyle and make small changes that will lead you to living a longer, healthier life.

Heart disease is the leading cause of death in both men and women. African American men are at the highest risk for heart disease. In America, one woman dies from heart disease every 80 seconds. What can both men and women do to make a difference in their heart health?

  • Book an appointment with your doctor to talk about your heart health. See if your diet and exercise regimen should be changed. Let your doctor know of any heart problems in your family’s history or any strange symptoms you’ve had or currently have.
  • Add exercise into your daily routine. Start off with a 15-minute walk a few times a week. Gradually work your way up to 30 minutes a few times per week.
  • Eat heart-healthy foods: lean meats, vegetables, fruits, whole grains. Avoid sugary treats, high sodium foods and fried foods.
  • Quit smoking. Quitting smoking can drastically cut your risk for both heart disease and stroke.
  • Talk to your doctor about medications you may need to help your heart, including high blood pressure and cholesterol medicines.

During the month of February, the American Heart Association wants to remind Americans to focus on their hearts to encourage a culture of health where making healthy choices is easy. The first American Heart Month, which took place in February 1964, was proclaimed by President Lyndon B. Johnson via Proclamation 3566 on December 30, 1963. Back then, more than half of American deaths were caused by cardiovascular disease.

This disease, unfortunately, still claims the lives of 17.3 million people each year across the globe. Fortunately, 80 percent of cardiac events may be prevented with education and lifestyle changes.

February 2 is National Wear Red Day. The American Heart Association teams up with Support Go Red For Women to help support programs that generate awareness and research to discover knowledge about cardiovascular health. To donate, click here.

February 22 is the 2nd annual Heart Valve Disease Awareness Day. According to the Alliance for Aging Research, “The goal of the National Heart Valve Disease Awareness Day is to increase recognition of the specific risks and symptoms of heart valve disease, improve detection and treatment, and ultimately save lives. While heart valve disease can be can be disabling and deadly, available treatments can save lives, making education and awareness particularly important.” To learn more, visit http://www.valvediseaseday.org.

Looking to take charge of your heart health? Don’t ignore the symptoms any longer and seek treatment.  If you suffer from heart disease, it’s time to talk to a heart valve surgeon about your options. Dr. Peter Mikhail is a heart valve surgeon who specializes in mitral valve surgery and TAVR. 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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Heart disease is the leading cause of death in the United States. Fortunately, people can lower their risk of developing heart disease by monitoring their diets. Overall, a diet low in saturated fats and low cholesterol, along with many other dietary factors, help lower one’s risk. Over the years, there have been many studies and articles have been written on “heart-healthy” foods for people to add in their diets. These foods are known to have anti-inflammatory properties, lower bad cholesterol, lower blood pressure, have antioxidants, and raise good cholesterol – all of which can help ward off heart disease. Throughout the years, soy products have been cited as a food source that lowers blood cholesterol levels and help provide other cardiovascular benefits. However, this has now changed.

In November, the FDA announced to revoke an authorized health claim about soy and heart disease. For the first time ever, the FDA is proposing a revocation. Back in 1999, the FDA approved the claim (to be used on packaged soy products) that soy protein can help reduce heart disease. Now, they’re changing their tune.

The Director of the FDA’s Center for Food Safety and Applied Nutrition, Susan Mayne, said in a released statement, “While some evidence continues to suggest a relationship between soy protein and a reduced risk of heart disease—including evidence reviewed by the FDA when the claim was authorized—the totality of currently available scientific evidence calls into question the certainty of this relationship.”

Apparently, after the FDA approved this health claim in 1999, there have been inconsistent findings regarding the ability of soy protein to help lower LDL (“bad”) cholesterol. Now, this doesn’t mean soy consumption increases a person’s heart disease risk, it just doesn’t reduce it.

This soy claim may change from an “authorized health claim” to a “qualified health claim.” A qualified health claim requires a lower scientific standard of evidence to explain the limited (but not definite) evidence linking soy protein intake with heart disease risk reduction.

The FDA will go through a full, official revocation process that will allow the public and industry stakeholders a chance to submit comments to the FDA to persuade it to keep the authorization. People can comment until January 18, 2018.

If you’re looking for heart-healthy foods that can help reduce one’s risk of developing heart disease, choose foods like nuts, salmon, berries, oatmeal, avocado, spinach, tuna, and olive oil.

If you are suffering from heart valve disease, Dr. Peter Mikhail is a thoracic and cardiac surgeon in New Port Richey, Florida who performs mitral valve surgery and TAVR.  He also treats patients in the Tampa and Clearwater areas. Dr. Mikhail advises his patients on the best diets based on their condition. To book a consult with Dr. Mikhail, click here or call his office at 727-312-4844.

 


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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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Keeping tabs on your health in today’s digital age is easier than ever before. But did you know that when it comes to monitoring your heart rate, a wrist-worn device isn’t as effective as one that’s strapped to your chest?

PC Magazine recently offered a review of 10 wearable heart monitors, and four out of the top five personal devices used chest straps to record heart activity. The magazine noted that chest-strap models, which use an electrical pulse to measure heart rate, are more accurate than wrist-worn devices that employ optical technology.

That finding is backed by a March 2017 report by the Cleveland Clinic, which tested five wrist-worn fitness trackers and came to the same conclusion – that monitors worn across the chest are more accurate at measuring heart rate while exercising.

Heart monitoring during sustained physical activity is especially important for individuals with heart murmurs and mild-to-moderate mitral valve regurgitation (MVR).

Here’s a list of the top chest-worn models (prices may vary):

Wahoo Fitness Tickr X Heart Rate Monitor: “The Wahoo Fitness Tickr X is the best heart rate strap you can buy. It’s so much more than just a heart rate monitor, and yet it costs the same as other excellent chest straps that don’t offer nearly as much. It doubles as a run tracker. You can use it with or without your phone.”

$99.99 MSRP; $79 at Amazon.com (http://amzn.to/2wCvvb1)

Polar H7 Heart Rate Sensor: “Polar users in need of an accurate HRM can’t go wrong with the H7, but it’s also good for anyone looking to add heart rate data to their run-tracking using one of the five supported apps. And if it works with your home or gym fitness equipment, all the better. The price is right, too. The Polar H7 is one of the most versatile and accurate HRMs available.”

$79.95 MSRP; $62.99 at Amazon.com (http://amzn.to/2gD39nJ)

Polar H10 Heart Rate Sensor: “If your current H7 chest strap is showing some wear and tear, you might want to think about upgrading to the H10. The extended battery life and built-in memory make it a solid investment, especially if you have or are thinking of getting a Polar fitness tracker.”

$89.95 MSRP; $89.95 at Amazon.com (http://amzn.to/2wCXrvr)

Garmin HRM-Run: “For runners who want a plethora of data, the Garmin HRM-Run gives you advanced stats including cadence, oscillation, ground contact time, ground contact balance, stride length, and vertical ratio. It makes for a pricey bundle when paired with a compatible tracker, but one worth considering.”

$99.95 MSRP; $83.74 at Amazon.com (http://amzn.to/2w3jkAu)

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 Dr. Mikhail’s Mitral Valve and Aortic Valve website 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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