False chord in children. False chords inside the left ventricle: to treat or not? What symptoms are characteristic of the anomaly?

The false chord of the left ventricle is an additional formation of the connective muscle-tissue structure.

It is attached to the wall of the septum between the ventricles of the heart, but is not connected to the valve leaflets. For the first time, doctors discovered additional chords at the end of the 19th century using an autopsy. But only in 1970 were their differences from true formations finally established.

Etiology of manifestations

The way a healthy heart works is to pump blood from the atria to the ventricles by opening and closing valves. The functional flexibility and mobility of the latter is provided by tendon threads, which, contracting and relaxing, alternately open and close the valves. In rare cases during pregnancy, when the formation of the main organs of the child occurs, the normal algorithm may fail. As a result, additional connecting threads appear. Most often this occurs in the left ventricle. These tendons do not have any special consequences for the activity of the heart muscle, so this condition is classified as a minor anomaly.

Additional threads of the left heart chamber are systematized in the direction of their location. Fibers with longitudinal or diagonal orientation do not oppose blood flow. Transverse filaments in the absence of constant cardiac monitoring in some circumstances can become a reason for the development of negative processes. It is necessary to understand that pathology with pre-excitation of the ventricles due to an abnormal connection (Wolff-Parkinson-White syndrome) and supraventricular tachycardia cannot be caused by abnormal formations. The reasons for the formation of a false chord are of different nature.

• Main risk factors:
• heredity (mostly passed on from the mother and very rarely from the father);
• negative impact of the ecological environment;

The pathology of the structure of the left ventricle of the heart mainly develops in males during embryonic development. Therefore, maternal heart disease, especially intoxication through alcohol or drug addiction, greatly increases the risk of the formation of additional fibers. If timely measures are not taken, the false threads will eventually transform into additional pathways for electrical signals. The likelihood of pathology occurring sharply increases with neuropsychological overload and lack of emotional balance.

Signs of pathology and diagnosis

Atypical threads are also found in the right ventricle of the heart, but most often in the left. They occupy the basal, middle or apical sections of the chamber. In more than half of the cases, the anomalous chord is the only one, in the rest it forms a group. Depending on the histology, the threads can be of three types: muscle, muscle-fibrous and fibrous. Currently, they are determined immediately after birth. If the pathology is not detected, then it may manifest itself in the future through the following symptoms:

• chest pain;
• good heartbeat audibility;
• general weakness and fatigue;
• vegetative disorders of cardiac activity;
• arrhythmia;
• the appearance of systolic murmur;
• fluctuations in blood circulation rate;
• violations of the anatomical structure of the left ventricle.

Today, several methods have been developed to determine the false chord of the left ventricle. Using the Doppler effect, the size, nature and density of the false formation are determined. Ultrasound helps to examine the external manifestations of pathology, and echocardiography gives an audio picture of its condition. For children less than 1 month old from the date of birth, it is recommended to perform only echocardiography. This is explained by the small size of the heart, so it is almost impossible to examine and measure anything. Usually, in a child, abnormal fibers in the heart show little sign of themselves, especially if the chord is single. In some cases, abnormal phenomena disappear spontaneously, without medical intervention.

Impact on quality of life and necessary therapy

Modern medicine is of the opinion that additional fibers in the ventricle can worsen the condition over time if they are not isolated, especially when found in the right chamber of the heart. With age, a person may develop diseases such as:

• endocardial disorder - in the case of a short chord;
• the appearance of fibrosis - proliferation, compaction of tissue, accompanied by the formation of scars;
• impossibility of relaxation after contraction;
• disturbances in the conductivity of electrical impulses;
• disorder of the biomechanical functions of the heart muscle.

Classical treatment of the pathology of additional fibers in the ventricles of the heart with the use of drugs is not prescribed, since the disease refers to minor cardiac anomalies. It is believed that a child should not be completely prohibited from leading an active lifestyle. You need to pay attention to proper nutrition, enhanced by fortified foods. To improve the conductivity of electrical signals, you should consume more foods containing the elements potassium and magnesium.

False chord of the left ventricle is one of the common types of small anomalies in the heart. Making this diagnosis is not a cause for great concern; it indicates that consultation with a cardiologist and constant monitoring are necessary. Most false chords in the left ventricle are not dangerous and do not threaten the patient’s life; there is only one type that can affect the functioning of the organ.

Interesting! Doctors have identified one pattern: in males, false cords are much more common.

Anomaly and its types, their characteristic features

To understand when a false chord in the heart is dangerous and what it is, it should be noted that in the structure of the myocardium there are tendon tissues in the form of threads (which are called chords). There are several of them, they are attached at one end to the valve, and at the other to the inner wall of the organ. The main purpose of these strands is to prevent the valve from bending and help it, when closing, to hold blood in the ventricle, preventing bending and reverse blood flow.

This anomaly is one of the most common

During intrauterine development, a disturbance in the structure of the myocardium may occur, for example, false chords are formed in the cavity of the left ventricle of a thicker diameter or with a slightly incorrect attachment. The first type is noted as “hemodynamically insignificant”, they do not affect the functioning of the organ at all and do not pose a danger. The second ones can behave differently, which depends on their fastening. They are:

• longitudinal;
• diagonal;
• transverse.

The first two types of attachment are also classified as “hemodynamically insignificant”, i.e. they are safe. The third, with transverse attachment, is called “hemodynamically significant” and requires more detailed study.

Clinical picture

False chord of the left ventricle of the heart in most cases does not manifest its presence and does not affect a person’s quality of life. Many patients with this diagnosis do not even suspect an anomaly in the main organ for years.

It should be noted that there are not only single anomalies, but also multiple ones. In this case, there is a connection between the false chord and heart block in the form of cardiac arrhythmias, early repolarization of the ventricles or their overexcitation.

The anomaly cannot be determined by listening, but in some cases the presence of a pathology can be suspected, as with many other heart pathologies. For example, a false chord and blockade of the legs of His may be accompanied by systolic murmurs in the upper part of the organ (the latter causing brighter sounds).

Deterioration in general health is often observed, such as:

• increased fatigue;
• weakness, lethargy;
• the appearance of pain in the chest;
• constant emotional stress.

Attention! With this anomaly, patients complain of the sensation of distinct sounds during heart contractions.

What can lead to an anomaly

What can lead to the development of minor anomalies in the heart is currently not fully understood, but the fact that this is a hereditary phenomenon has been proven. If such a phenomenon is detected in the mother, there are defects or diseases of the cardiovascular system, then a false chord is detected in the heart and in the child.

Ultrasound of the heart will help identify the disease

Doctors suggest that some other dangerous factors can lead to abnormalities. All causes of false chord of the left ventricle are associated with the lifestyle of the expectant mother during pregnancy (after all, this is a congenital phenomenon). These include:

• living in an environmentally polluted area;
• radiation exposure;
• weak immunity of women;
• infections transmitted to the fetus;
• smoking during pregnancy, drinking alcoholic beverages;
• stress and other psycho-emotional stress.

What diagnostics and therapy are prescribed?

If the doctor detects murmurs during auscultation (listening), or the patient’s visit contains the above signs indicating problems with the heart, you must undergo:

• electrocardiogram (ECG);
• ultrasonography.

With a false chord in the left ventricle in a child or adult, an accurate diagnosis, as well as the location of the cord and possible danger, can only be determined by ultrasound.

In most cases, no special treatment is required, you just need to take control of your heart function and lead a healthy lifestyle. If the false chord causes discomfort or is accompanied by some characteristic signs, then drug therapy may be prescribed. It can be:

• vitamins (to improve nutrition of organ cells);
• antioxidants (for metabolism in cells);
• nootropic drugs (if a functional disease is detected).

Important! Surgical interventions are an extremely rare occurrence; they can only be indicated for a “hemodynamically significant” type of anomaly, and only if it interferes with the functioning of the organ.

What to do if an illness is detected

If a false chord is detected in a child, it is not a reason to panic, but you should make it a rule to undergo regular, annual examinations by a cardiologist.

Vitamin complexes will help keep the body in good shape

In addition, there are a few more adjustments that should be included in the normal rhythm of life.

• Physical activity should not be excluded; it is needed for the general strengthening and development of the body. However, it is important to distribute them correctly: avoid overwork and do not count on professional sports. Boxing, mountaineering, and parachuting are not recommended.
• It is recommended to engage in physical therapy (you can do this on your own or attend classes at medical centers):

1. classes with sports equipment (hoop, ball, jump rope, rope, wall bars);
2. rhythmic movements and dance steps.

• It is imperative to follow a daily routine, set aside enough time for proper rest and sleep, as well as daily walks in the fresh air.
• You should pay special attention to nutrition. It should be rich in vitamins (especially those belonging to group B) and microelements (potassium, magnesium).
• Stress and emotional overstrain should be avoided.

Important! Patients with this diagnosis must adhere to all existing preventive measures for infective endocarditis.

Girls, whose child had this diagnosis? We were diagnosed in the maternity hospital on the second day after birth based on a heart ultrasound. They say we will outgrow it, it happens to many people. There is still an open oval window. My sister, by the way, also has this diagnosis, but she is already 18 years old, and she still hasn’t outgrown it... Share your experience, and maybe I need to do something NOW (before it’s too late) to avoid the risk that will not outgrow. Maybe there is something you should include in your diet or not allow...

And we heard these symptoms from the doctor.

And this is what the Internet writes about it. MARS syndrome. Diagnosis as if from outer space Many parents begin to worry if the mysterious abbreviation MARS (or minor anomalies of cardiac development) appears on their child’s card. Such anomalies have always existed; these are not newly emerging diseases. From time immemorial, various deviations in the structure of internal organs, including the heart, have been identified - unfortunately, usually posthumously. Today, MARS is detected in children almost from birth, this allows for a fairly simple, informative and painless method of research -...

False chord of the left ventricle is considered a minor cardiac anomaly. This is an additional muscle-tissue formation of a connective nature. The notochord is attached to the opposite walls of the ventricular septa. Most often, this anomaly is observed in representatives of the stronger sex.

In medicine, this diagnosis is quite common. But it does not apply to life-threatening pathological conditions. The patient is required to review his lifestyle and undergo regular examination by a cardiologist. If an anomaly is found in a child, then this is not a death sentence. There is no need to limit his activity, attending school, or communicating with peers. It is worth giving up only professional sports when the body is under constant physical stress. Parents need to monitor the well-being of their child and undergo regular medical examinations.

Ways to manifest an anomaly

False chord can form due to a hereditary factor. It is genetic predisposition that is considered the main root cause of the formation of the anomaly. If a pregnant woman is diagnosed with a heart disease, then the percentage of heart pathology in a newborn baby is very high. But the reasons include the harmful influence of the external environment, the impact of mutagenic elements (nicotine, alcohol, drugs). Various harmful habits have a particularly negative effect on the embryo until the sixth week of development, when the formation of connective tissue occurs.

There are no specific manifestations in a single anomalous formation, but false chord and His blockade can be detected due to specific systolic murmurs that are not typical for a healthy body. The difficulty of diagnosis lies in the absence of symptoms in the initial stages or with a single formation. Murmurs may also not be audible, so auscultation alone cannot be relied upon.

As a rule, an additional chord is detected in a child immediately after birth. If it is not detected, then after a while the following signs may appear:

• heart pain, the intensity and frequency of which may vary;
• a feeling of contractions of one’s own heart (in a normal state a person does not hear the rhythm);
• general weakness, high fatigue without objective reasons;
• autonomic dysfunction of the organ;
• psychological stress.

The connection between false chord and heart block is arrhythmia, early restoration of the original parameters of the heart chambers, or their overexcitation.

Note! In most cases, the presence of such an anomaly does not affect the health and well-being of the child. Therefore, parents should not panic; it is enough to follow the doctor’s simple recommendations.

Key examination methods

False chord in the heart - what is it? To determine its characteristics and effect on the body, the physician prescribes instrumental research methods:

• initial examination with listening to the heart to determine the presence and nature of the murmur;
• EchoCG – ultrasound examination may reveal a dense linear anomaly;
• ECG - necessary to determine a problem with the heart rhythm;
• daily ECG monitoring;

The doctor will decide what examination the patient needs to undergo. In most cases, an ultrasound of the heart is sufficient. Additionally, other examinations may be prescribed if there are concomitant diseases of the cardiovascular system or if it is necessary to clarify the effect of the pathology on the contractility of the heart.

Optimal methods of therapy

Without pronounced symptoms of left ventricular false chord in a child, there is no need to prescribe drug therapy. You only need to regularly visit a cardiologist, undergo an echocardiogram and an ECG at least once a year. Such preventive measures make it possible to monitor the patient’s well-being over time and, if necessary, begin therapy.

When symptoms of cardiovascular pathologies appear, groups of medications are prescribed. They are aimed at normalizing the condition and eliminating the symptoms of the abnormality.

1. The vitamin complex is necessary to improve the nutrition of the heart muscle. The vitamin course lasts at least one month and is repeated at least once a year.
2. Normalization of the process of conducting an electrical impulse, which can provoke arrhythmia. Prescribe medications with a high content of magnesium and potassium. The course of taking these funds is also about a month. The dosage is prescribed by the doctor individually, taking into account the patient’s age, the severity of the disease, the presence of other diseases and the individual characteristics of the body (the presence of an allergic reaction to certain medications).
3. Antioxidants are necessary to restore metabolic processes. Without normalizing metabolism, it will not be possible to improve the patient’s health, but thanks to taking this group of medications, it is possible to bind and neutralize free radicals.
4. Nootropic drugs are aimed at combating neurocirculatory dystonia. They significantly increase the body’s energy potential and stimulate the central nervous system, as well as activate natural defense mechanisms.

It is imperative to adhere to a healthy lifestyle and carry out certain health measures:

• harden the body - hardening helps strengthen blood vessels and increase overall resistance to temperature changes and colds;
• balance the body, enrich your diet with vitamins and other beneficial elements that are necessary for the normal functioning of all internal organs, including the heart;
• spend a lot of time outdoors;
• maintain a work and rest schedule, avoiding overload at school and at work, and we are talking about both physical fatigue and stressful situations;
• engage in moderate physical activity - sports are always necessary, but the permissibility of the load is determined by the doctor.

Transverse multiple chords can provoke arrhythmia and associated pathological conditions. Diseases that progress on this basis can have a lot of negative consequences and complications. In these cases, careful diagnosis and treatment in a hospital under the supervision of a cardiologist is required.

In particularly difficult cases, cryodestruction (the chord is exposed to cold) or excision of the formation may be required.

It is not always possible to say whether a pathology threatens dangerous complications. The presence of a chord is not considered a dangerous phenomenon for the health of the body if the abnormal formation does not provoke disturbances in the functioning of the cardiovascular system. Complications with an additional chord appear in extremely rare cases. Regular use of medications reduces the possibility of complications to a minimum. The only condition is that you must take only those medications recommended by your doctor, and only in the prescribed dosage. The use of incorrectly selected medications can provoke heart rhythm disturbances and other pathological conditions.

The prognosis for life with this diagnosis is favorable if there are no hemodynamic and arrhythmogenic disorders.

The child can lead a normal lifestyle without significant changes or restrictions. The key rule in this case is a healthy lifestyle and control of pathology.

There are several chords in the human heart that prevent the valve from bending during contraction of this organ. Thanks to their presence, it retains blood well and ensures adequate hemodynamics. The normal chord is a kind of spring with a muscular structure. Sometimes during intrauterine development, an additional notochord appears in one of them, which is a thread-like cord of connective tissue. In some cases, this abnormal formation includes muscle or tendon fibers.

In this article we will look at such a minor cardiac anomaly as an accessory chord of the left ventricle. In most cases, it is found in children under 18 years of age, but some people live with this diagnosis for many years and do not feel any changes in the functioning of the heart. Usually, an additional chord is detected by chance: during an examination for another disease or during a preventive examination. It is not detected either by listening to a heart murmur or by an ECG, and an accurate diagnosis can only be made after an ECHO-CG. Having heard a heart murmur, the doctor can only suspect the presence of this minor heart anomaly and recommend an ultrasound examination to refute or confirm the diagnosis.

In our article we will introduce you to the causes of development, types, symptoms, methods of observation, treatment and prevention of accessory chord of the left ventricle. This knowledge will help parents of children with such a heart anomaly choose the right tactics to approach the problem and save them from unnecessary worries.

An abnormal chord of the left ventricle is a hereditary anomaly, which in 92% of cases is inherited through the maternal line (in rare cases, through the paternal line), and develops in utero due to a failure in the development of connective tissue. That is why mothers who have previously been diagnosed with this disease are recommended to have their child examined.

It is possible that the following unfavorable factors may be the reasons for the appearance of an additional chord:

• bad ecology;
• smoking or drinking alcohol and drugs;
• nervous and physical stress.

Kinds

The additional chord can be located in different parts of the left ventricle and have a different structure and structure. Cardiologists distinguish the following types of chords:

• by histological structure: fibrous, fibromuscular, muscular;
• in the direction of the connective tissue fibers: longitudinal, transverse, diagonal;
• by the number of threadlike strands: single, multiple;
• by place of attachment: apical, middle, basal.

Symptoms

In most cases, the additional chord of the left ventricle does not bear any functional load on the heart and does not interfere with its normal functioning. For many years, this minor anomaly may not be detected, because it is not accompanied by any special symptoms. A pediatrician can listen to a systolic heart murmur in a newborn, which is detected between the third and fourth ribs to the left of the sternum and does not in any way affect the functioning of the heart.

During intensive development, when the rapid growth of the musculoskeletal system significantly outstrips the growth rate of internal organs, the load on the heart increases, and the additional chord may make itself felt for the first time. Your child may experience the following symptoms:

• dizziness;
• rapid or unmotivated fatigue;
• psycho-emotional lability;
• cardiopalmus;

The same clinical manifestations can be observed with multiple abnormal chords of the left ventricle. Most often, such symptoms appear during adolescence. In the future, they can completely disappear on their own, but sometimes they remain in adulthood.

When symptoms appear, the child must be prescribed ECHO-CG, ECG, etc. These studies will allow the doctor to determine the presence or absence of hemodynamic disturbances. If the additional chord is “hemodynamically insignificant,” then the anomaly is considered safe, and the child only requires follow-up with a cardiologist. With a “hemodynamically significant” diagnosis, the patient is advised to observe, adhere to certain restrictions and, if necessary, treatment.

Is the accessory chord of the left ventricle dangerous?

Most cardiologists equate such a minor cardiac anomaly with a variant of the norm. The news of the presence of an additional chord in the left ventricle should not cause panic in the child’s parents, since this anomaly does not require surgical treatment and, in the absence of hemodynamic disturbances, does not require drug correction.

In some cases, an additional chord of the left ventricle may become a factor that contributes to the development of other diseases of the heart and blood vessels (disorders of cardiac rhythm and conduction, etc.). It is impossible to predict in advance how likely the development of such pathologies is.

Observation of a child with an additional chord in the absence of hemodynamic disturbances

If an abnormal chord is detected that is not accompanied by symptoms, no special treatment is required. For such patients, it is enough to be regularly monitored by a cardiologist and undergo a control ECHO-CG once a year.

• observe the work and rest schedule;
• Healthy food;
• engage in physical therapy;
• to harden;
• often be in the fresh air;
• prevent stress;
• ensure proper sleep;
• refuse heavy physical activity;
• do not take medications without doctor’s recommendations;
• make a decision about participating in a particular sport together with your doctor.

Parents of such children are not recommended to protect their child from everything and treat him as a disabled person, since this can significantly affect his further socialization. Communication with friends, visiting kindergarten and school, participating in clubs and feasible sports - all this will help the child adapt normally to society and feel complete.

Treatment

If an additional chord is detected, which is accompanied by symptoms or hemodynamic disturbances, in addition to the recommendations described above and more stringent restrictions on physical activity, drug therapy is recommended.

These children may be prescribed the following medications:

Indications for immediate hospitalization in a cardiology hospital may include the following severe heart rhythm disturbances:

• Morgagni-Adams-Stokes syndrome;

They can develop with multiple or transverse chordae and require detailed examination and subsequent treatment.

In rare cases, muscle fibers of the cardiac conduction system may be included in the structure of the accessory chord of the left ventricle. Such cardiac abnormalities can cause ventricular arrhythmias and ventricular fibrillation. To eliminate them, the following surgical interventions are indicated:

• cryodestruction;
• excision of the chord.

Prevention

In most cases, an additional chord of the left ventricle appears due to a hereditary predisposition, and it is almost impossible to prevent its development in the prenatal period. Despite this, scientists do not exclude the possibility of the development of such a minor cardiac anomaly under the influence of certain unfavorable factors. That is why pregnant women are recommended:

1. Eat properly.
2. Stop smoking, drinking alcohol and drugs.
3. Avoid heavy physical activity.
4. Prevent stress.
5. Walk in the fresh air and do gymnastics.

If an additional chord of the left ventricle is detected in a child, parents should pay close attention to his health, follow all the doctor’s recommendations, but not completely protect him from society. An important measure to prevent complications will be the timely treatment of chronic diseases that can be complicated by heart disease.

Children with an additional chord are recommended to regularly engage in physical therapy, which involves individual selection of the load. Wall bars exercises, dancing, gymnastics, sprinting, jumping rope - these activities will help strengthen the heart muscle and prevent the development of complications.

Physical activity should not be excessive, as it can aggravate the situation. Most cardiologists do not recommend that people with accessory chordae engage in professional sports. And such types of stress that occur during diving, snorkeling or parachute jumping are absolutely contraindicated.