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MITRAL VALVE BLOG

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Aortic stenosis is a condition that is growing as the U.S. population grows. Right now, it is estimated that 2.5 million Americans over 75 suffer from this heart valve disease, which accounts for 12.4 percent of the population.  Between now and 2050, the elderly population will more than double to around 80 million.

Aortic stenosis affects men more often than women. In fact, 80 percent of adults with aortic stenosis are male. What is aortic stenosis exactly? With this condition, the aortic valve’s flaps (cusps) have thickened or become stiff and could possibly fuse together, which narrows the valve. The valve’s opening becomes narrowed and blocks/reduces blood flow from the heart into the aorta and to the rest of the body.

A person with aortic stenosis will experience the following symptoms: shortness of breath, heart murmur, dizziness, fainting, chest pain, chest tightness, irregular heartbeat, and swelling of the ankles and feet.

The disease is often misdiagnosed and undertreated. A severe case of aortic stenosis can be fatal; some doctors refer to the disease as a “silent killer.”  It is a progressive disorder, and the onset of the symptoms and progression will vary from patient to patient. As a person gets older, the aortic valve disease will continue to progress, regardless of what the patient does or doesn’t do.

Since nothing can reduce the progression of this disease, patients are instructed to visit their cardiologist annually, and have an echocardiogram to evaluate is the disease is becoming more severe.  Aortic stenosis has three progression stages: mild, moderate, and severe.  As stated earlier, a person can experience an array of different symptoms with this disease. If a person is experiencing symptoms, it is often a sign of a progression of the degenerative process, and the person should have the doctor assess them immediately.

If a person gets to the point in which he or she needs an aortic valve replacement, they have more options for surgery than ever before. These days, there are less invasive approaches to aortic valve replacement such as transcatheter aortic valve replacement (TAVR).  TAVR is good for people who have been diagnosed with severe aortic valve disease and are at an intermediate or high risk for open heart surgery. Most people who have this procedure are in their 70s or 80s. In this surgery the doctor inserts a catheter in a leg or chest and guides it to the heart. A replacement valve is inserted through the catheter up to the heart.

Do you suffer from aortic stenosis? If you need an aortic valve repair or an aortic valve replacement, Dr. Mikhail is a cardiac surgeon based in New Port Richey, Florida, who specializes in heart valve surgery. 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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Today, we are going to discuss a treatment method for aortic stenosis and aortic regurgitation – two serious conditions that affect the heart’s aortic valve – called Mini-AVR.

First, let’s talk about what those conditions are.

Aortic stenosis occurs when the cusps of the aortic valve become abnormally rigid and do not fully open. This narrowing of the valve creates resistance against the pumping of blood from the left ventricle to the rest of the body, and if left untreated, it can lead to heart failure.

Typically, this condition is the result of degeneration due to natural aging and health issues and calcium buildup on the valve cusps over time causes them to stiffen.

Aortic regurgitation occurs when the aortic valve allows blood to leak back into the left ventricle. It’s often caused by valve damage due to a recent infection or rheumatic heart disease, or it’s a congenital heart defect you were born with.

The symptoms of both conditions include shortness of breath, chest pain or heaviness, fainting or lightheadedness, decreased physical endurance during exercise, and swelling of the limbs.

The severity of aortic stenosis and aortic regurgitation will determine treatment. A Minimally Invasive Aortic Valve Replacement, or Mini-AVR, involves the surgical replacement of the aortic valve with a prosthetic valve. Its benefits include less trauma and pain, better cosmetic results, a shorter recovery time, and a potentially lower financial cost.

During Mini-AVR surgery, a small incision is made in the upper chest area, and a cardiopulmonary bypass machine is used to take over functions of the heart and lungs, so that blood continues to flow around the heart and the body’s oxygen levels remain stable. A surgeon will open the aorta (and, if necessary, remove any diseased valve cusps), measure the valve ring, and insert the prosthetic valve.

The surgery typically takes about 2 to 3 hours. Several recent studies have shown that a Mini-AVR procedure is potentially safer than a conventional AVR procedure with a full sternotomy, which calls for much larger incision.

It’s important to talk to your doctor about the best treatment options for aortic valve conditions. In some cases, medication may be effective treatment for aortic regurgitation. However, receiving timely surgery is often advised because a significant delay could lead to congestive heart failure.

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 Mitral Valve contact page 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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We all know that exercise and physical health go hand-in-hand. But did you know that exercising can help prevent heart disease and stroke, and even help individuals with some minor heart conditions?

The American Heart Association recommends getting at least 150 minutes per week of moderate exercise — or 75 minutes per week of vigorous exercise — to improve overall cardiovascular health. For individuals looking to lower their blood pressure or cholesterol levels, the organization recommends 40 minutes of moderate-to-vigorous aerobic exercise three to four times per week.

Aerobic exercises include walking, jogging, swimming, or biking.

Your heart is a muscle, and it gets stronger and healthier if you lead an active lifestyle. The resting heart rate of a person who stays active is slower than a non-active person, because less effort is needed to keep blood pumping. People who don’t exercise are twice as likely to develop heart disease compared to those who stay active.

Exercise promotes weight maintenance and reduction, and can reduce “bad” LDL cholesterol levels in the blood. Those “bad” lipoproteins lead to plaque buildup in the arteries, which narrows vital pathways for blood flow and raises the risk of heart attack and stroke.

Some cardiologists recommend combining short bursts of high-intensity exercise with slightly longer periods of recovery, so that the body becomes more efficient at clearing fat and sugar from the blood. Weight training can also help with heart protection for healthy individuals.

It’s been shown that exercise decreases symptoms of angina and heart failure, and even overweight people who have trouble shedding pounds can still achieve heart benefits with routine physical activity.

Experts also agree that the worst kind of exercise for heart health is “overdoing it” with vigorous physical activity without prior training, such as shoveling snow. The excessive adrenaline that is released throughout the body can lead to a sudden heart attack.

For people with mild-to-moderate mitral valve regurgitation (MVR) without symptoms, regular activity – even if it’s walking – will help heart functions. Using a treadmill with a digital heart monitor is one of the easiest ways to work out while keeping tabs on your pulse.

It’s important to note that people with MVR who are experiencing irregular heart rhythms should be cautious about physical activity, avoid a high-intensity workout, and consult their doctors about what type of exercise is appropriate.

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 our Mitral Valve  contact page or call 727-312-4844.

 


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Heart disease is the Number One killer in America. Some people are born with heart disease. Some people have a buildup of fatty plaque in their arteries due to lack of exercise, smoking or an unhealthy diet. Some people develop heart issues from drug habits or stress.  Some people develop heart disease from high blood pressure. Some people have heart issues from trauma or infection. As you can see, there are many ways a person can develop heart disease, which means it’s in your best interest to do everything within your power to ward off the disease.

No one lives a perfect life. No one has the ideal diet. People skip workouts. People don’t sleep enough. Accidents happen.  But we can help ourselves by trying to lead the healthiest lives possible to keep our hearts strong so we can live longer, happier lives.

Making a lifestyle change for better heart health can be overwhelming for some, so we want to share with you some real, basic tips on everyday things you can do to improve your heart health and lower your risk of heart disease.

  • If you have to lose a lot of weight, don’t stress. Set your weight loss goals at small increments. Aim for 5 pounds, then aim for another 5 pounds. It’ll add up quickly and these smaller increments will seem far more attainable than saying, “I need to drop 60 pounds.”
  • Incorporate more fresh fruit and vegetables in your diet. Your body needs a variety of different vitamins and minerals to function properly. Try to eat around 5 servings of fruit and veggies per day.
  • If you smoke, quit! It is easier said than done, but if you quit you lower your chance of developing heart disease or having a heart attack by 50 percent!
  • Aim for 7 to 9 hours of sleep per night. Research has shown that proper rest reduces a person’s chance of developing heart disease.
  • Exercise keeps your heart healthy. 30 minutes of exercise a day is ideal to keep your heart in a heathy state. If 30 minutes is too much for you, you can split it into two 15-minute segments of exercise or three 10-minute segments throughout the day.
  • Stay hydrated! When your body and blood are well hydrated, the heart doesn’t have to work as hard to pump and keep the blood flowing.

Changing your lifestyle to promote better heart health doesn’t have to be a daunting, overwhelming task. Take it one step at a time! Slowly start incorporating the above list in your daily habits, and I bet you’ll start feeling better!

If you currently suffer from heart disease, including mitral valve disease or aortic valve disease, and are considering surgery, you should book a consult with Dr. Peter Mikhail. Dr. Mikhail is a cardiac and thoracic surgeon who performs mitral valve surgery and mini-AVR on patients with mitral valve or aortic valve disease. He treats patients in the Tampa, Clearwater and New Port Richey areas of Florida. 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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