What is a false chord and where does it come from?
Inside the left ventricle there are papillary muscles and true chords - threads that hold the mitral valve leaflets and prevent them from sagging. Sometimes during intrauterine development an extra cord is formed that stretches from wall to wall or to the septum and has nothing to do with the valve. This is a false chord. It can be single or multiple, longitudinal or transverse. Such cords are classified as minor anomalies in the development of the heart, together with an open oval window and small mitral valve prolapse, and are often found in people with signs of connective tissue dysplasia.
- Strand inside the cavity of the left ventricle
- Not connected to the mitral valve leaflets
- Formed before birth, does not appear in adults
- Can be single or multiple
- Often combined with other minor anomalies
Why does a heart murmur occur?
The transverse cord is in the path of the blood flow that is ejected from the ventricle. The flow flows around it, a vortex occurs, and the doctor hears a soft, musical systolic murmur. Such a murmur is called functional: it is not associated with narrowing or insufficiency of the valve, changes with changes in body position and is not accompanied by other signs of heart disease. It is this noise that most often becomes the reason to refer a child for echocardiography. It is important that the murmur itself is not a diagnosis, and the purpose of the examination is to exclude heart defects.
- The murmur is soft, musical, systolic
- Changes when body position changes
- Not accompanied by shortness of breath and blueness
- Does not require treatment on its own
- Similar noises occur with anemia and fever
Does chorda affect health?
In the vast majority of cases, the additional chord has no effect on well-being, heart performance or life expectancy. Complaints of fatigue, tingling in the heart, and dizziness in adolescents are usually associated not with the notochord, but with a period of rapid growth, autonomic reactions, iron deficiency, or low blood pressure. The role of transverse cords in the occurrence of rhythm disturbances is discussed separately: fibers of the conduction system pass through some of the cords, and if there are complaints about interruptions, the cardiologist prescribes an additional examination.
- The pumping function of the heart is not affected
- Chamber sizes and valves remain normal
- Complaints are more often associated with other reasons
- Possible connection with extrasystole with transverse cords
- Does not require disability or special treatment
Survey
The diagnosis is made by echocardiography: the doctor sees a thin cord stretched in the cavity of the left ventricle, and at the same time evaluates the valves, septa, chamber sizes and pressure in the pulmonary artery. To assess the rhythm, an ECG is done, and if a child or adult complains of irregular heartbeats, palpitations or fainting, 24-hour monitoring and a stress test are added. With severe fatigue and pallor, it makes sense to check a general blood test so as not to miss anemia, which in itself causes noise and weakness.
- Echocardiography is the main method
- ECG, including rhythmogram in children
- Daily ECG monitoring during interruptions
- ECG with physical activity according to indications
- General blood test for weakness and pallor
- Examination by a cardiologist with murmur assessment
Observation, sports and treatment
It is not necessary and impossible to treat the chord itself: no one will remove the cord surgically if there are no violations. A one-time consultation with a cardiologist and, according to his decision, a control echocardiogram several years later is sufficient. Physical education and most sports are allowed, and before professional exercise a routine sports examination is carried out. If significant rhythm disturbances are identified, they are treated by a cardiologist or arrhythmologist. There is no need to take medications “to strengthen the heart muscle” without an established diagnosis.
- No special treatment required
- Control echocardiography according to the decision of the cardiologist
- Physical education and sports are usually allowed
- Treatment is prescribed only for proven arrhythmia
- Adequate sleep, exercise regimen, smoking cessation in adolescents