What does the additional chord in the heart affect? An additional chord in the left ventricle of the heart is an anomaly that everyone should know about. Doctor Komarovsky's opinion

Periodic stabbing pain in the heart area, sensations of interruptions in its work. Who hasn't encountered such symptoms? Few people do not understand what we are talking about. When addressing the listed complaints to a doctor, most often a person receives a recommendation to undergo an echocardiogram in addition to an ECG.

Of course, the study may reveal gross pathology, for example, decreased contractility of the walls or heart defects. But often, especially in children and young people, the diagnosis is made in conclusion: accessory chord (AC). Many questions immediately arise, since the term is little known. The article will tell you what an additional chord means, the reasons for its development, symptoms, treatment and methods of diagnosis and prevention.

A little anatomy

The heart is divided into 4 chambers: 2 ventricles, 2 atria. The right chambers are separated by the tricuspid valve, the left by the mitral valve. Their work is controlled by papillary (papillary) muscles. True chords originate from them. At the other end they are attached to the flaps of the valves mentioned above.

Normally, blood flows through the veins into the atria and then into the ventricles. During contraction of the latter, blood must flow into the aorta and pulmonary trunk. The valves block its return to the atria. The true chords prevent the valves from bending into the atrium cavity, keeping them closed.

Definition

Chordae are connective tissue threads attached at one end to the papillary muscle and the other to the valve leaflet. What does “additional ventricular chords” mean? The false chord also originates from the papillary muscle, but can be attached to all structures except the valve.

All over the world, an additional ventricular chord is classified as a minor developmental anomaly. However, in Lately Many experts agree on the need to revise the classification. This is mainly due to the high prevalence of the diagnosis among the population.

Falshchords are most often detected by chance during clinical examination and are most often found in children. If the doctor does not like the results of the ECG, or he listened to a heart murmur, then the patient is sent for an echocardiographic study to determine the cause. Noises and ECG changes can be caused by dozens of different heart pathologies. And the additional chord is the most insignificant among them.

Causes of occurrence.

In the medical community, it is generally accepted that genetic predisposition is the main reason for the appearance of additional chordae. This developmental feature is inherited from the mother. But we shouldn't discount external factors effects on the fetus through the body of a pregnant woman:

smoking;
alcohol consumption;
taking narcotic substances;
poor environmental conditions;
stressful situations;
uncontrolled reception medicines.

It must be remembered that all of the above leads not only to the formation of additional chords, but also to much more severe consequences. These are fetal malformations that are incompatible with life or seriously impair its quality.

Classification.

False chords are divided into several categories:

tissue structure: fibrous, muscular, fibromuscular;
location in the heart: in the right or left ventricle;
fiber direction: transverse, longitudinal, diagonal;
number of false chords: single and multiple;
place of attachment: basal, median, apical.

False chords are also classified into 3 types in relation to other structures:

Signs

An additional chord in the ventricular cavity often does not manifest itself clinically. The person does not complain about anything and does not even think about his health. The only way a false chord can give itself away is a systolic (during the muscle contraction phase) murmur in the heart. The absence of symptoms is typical for relatively quiet periods of child development or for adults.

However, during rapid growth of the organism, especially in teenage years, as well as with multiple additional chords, can cause more significant changes in hemodynamics. Heart murmur it will be louder. Among the symptoms you can observe:

general weakness;
fatigue;
dizziness;
stitching pain in the region of the heart;
a feeling of interruptions in his work;
increased heart rate.

The body needs to rebuild itself, so some hemodynamic disturbances occur. After overcoming the described stage of development, symptoms may disappear, rarely remaining for life.

It is extremely rare that the false chord may contain pathological pathways that conduct impulses. This is how they develop life threatening arrhythmias (paroxysmal tachycardias, SVC syndromes and Morgagni-Adam-Stokes).

Complications

When a person is seriously diagnosed, false chords can aggravate the patient's condition. For example, if infectious myocarditis initially develops on the valves, then colonies can also develop on the DC. In this case, the risks of vegetation separation (bacterial growths) increase with subsequent entry into the general bloodstream and blockage of the arteries.

Similar processes occur during myocardial infarction. Due to reduced heart function, the speed of blood flow in the cavities slows down. Due to the presence of false chords, especially multiple ones, the risk of blood clots increases.

Diagnostics

Examination of a patient always begins with an examination. Often the diagnosis of DH is made in conjunction with connective tissue dysplasia. In this case, the patient has too much high growth, thinness of physique, frequent dislocations of joints, their increased mobility.

An important stage of diagnosis is listening to heart sounds and identifying If such important feature the patient is sent for electrocardiography.

Method shows electrical activity hearts. Recording an ECG in the presence of HD may reveal various disorders heart rhythm: from extrasystoles to paroxysmal tachycardias. If the results are questionable, the doctor may prescribe a long-term ECG recording (Holter monitoring) or an ECG with physical activity (bicycle ergometry, treadmill test).

IN mandatory A patient with a heart murmur is referred for echocardiography. allows you to examine the structure of the heart, evaluate its work, detect and describe false chords. The speed of blood flow through each valve, the presence of turbulence in the cavities, how the heart muscle relaxes and contracts - all this helps the doctor judge the function of the heart and the possibility of the influence of DH on hemodynamics.

Used last. This is the most reliable way to identify the mechanisms of rhythm disturbances. It can be invasive (from inside the heart) or non-invasive (through the esophagus). In both cases, an ECG is recorded at rest and during diagnostic stimulation.

This way, additional pathways are identified that may also exist in the DH. All methods together give the doctor a complete picture of the disease, on the basis of which he makes a decision on further management of the patient.

Treatment

Let’s say a doctor diagnosed a patient with “additional chord of the left ventricle.” This means that she is alone and you shouldn’t be afraid of her. Especially if the person is not experiencing any symptoms. Besides, most of The medical community considers a hemodynamically insignificant false chord to be a normal variant, and it does not require treatment. However, it is still worth monitoring her and undergoing an ECG and ECHO-CG once a year, not more often.

If the symptoms bother the patient, then it is prescribed drug therapy. It is mainly of a general strengthening and calming nature:

Vitamins B1, B2, B6, B12 improve processes nervous regulation.
Preparations containing magnesium and potassium help stabilize vascular tone and neuromuscular transmission.
Nootropics increase the body's resistance to physical stress and accelerate cognitive, that is, thinking, processes in the brain. Antioxidants improve metabolism in the heart.

In the presence of severe arrhythmias and hemodynamics, the doctor prescribes more serious drugs that restore the correct sinus rhythm.

With the development of life-threatening rhythm disturbances ( atrial fibrillation, paroxysmal tachycardia, syndromes premature contraction ventricles) requires urgent hospitalization. If such conditions recur, and according to the results of examinations (EPI), it turns out that the cause is the false chord, then it is necessary to consider surgical treatment options: cryodestruction (destruction by cold) or dissection of the additional chord.

An auxiliary method of therapy is to maintain the healthiest lifestyle possible. In order not to think about the disease, it is enough to follow the following recommendations daily:

walk in the fresh air in a park, outside the city for at least an hour;
exercise regularly;
eating vegetables and fruits;
reduce the amount you eat fast carbohydrates»: sweets, bakery products;
refusal of smoking, alcohol, drugs;
go to bed before 10 pm, because it is until midnight that the body rests most effectively;
sleep duration is 7-8 chats or more;
keep positive attitude and smile more.

The listed measures are not only a method of treatment, but also help prevent the development of other diseases. By following simple tips, you can seriously improve your well-being and forget about all your ailments.

Forecast

After diagnosis, people wonder whether the additional chord is dangerous. The prognosis of the disease in the vast majority of cases is favorable, but in one case important condition. A person should not experience symptoms that worsen his well-being. If the patient has a severe rhythm disturbance, the prognosis is somewhat worse. But even in this case, the pathology can be treated. The main thing is to identify it in time.

An additional chord in the heart is a pathology often found in children. But such a disease does not pose a great danger. The common chord is a muscle that connects the 2 opposite sides of the left ventricle of the heart.

The extra chord is superfluous in the left ventricle and has an atypical structure. As a rule, it is located in the left ventricle, much less often in the right. For a long time, doctors studied this anomaly of the location of the chord in the left ventricle. Experts came to the conclusion that the disease does not affect the functioning of the heart and does not pose an additional danger to life for the child.

Most often, the additional chord n located in the child's left ventricle, specialists find it much less often in adult patients. The disease is easier to detect in a child because the child's heart small size and in it the noise is more easily distinguished. When a chord is detected in the heart, the patient does not experience any preliminary symptoms.

Very often, doctors find the disease by accident, because when listening to the heart, murmurs are detected. If the cardiologist detects a heart murmur, the patient is given a referral for an ECG. After the procedure, the patient is diagnosed with a chord. In medicine, there are cases where the chord was false, but murmurs were still observed in the heart.

For what reasons does an additional chord appear in a child’s heart?

The cause of the disease is heredity. The disease is transmitted through the maternal line. Perhaps the child’s mother suffered from a similar disease or some other heart disease.

Treatment of an additional chord in the heart

This disease does not pose any danger. No special treatment is required. But if the disease is detected in the patient, he is prescribed a gentle lifestyle. The patient should have limited physical activity.

The doctor will prescribe quiet physical therapy. A sick person should never be overexerted physically. It is imperative that alternate work and rest.

A sick person must eat properly and follow a strict daily routine.

The doctor will prescribe stabilization treatment nervous system.

Nervous shock is contraindicated for a patient with this disease. It is mandatory to see a cardiologist twice a year. Noises, which arise due to the chord, may interfere with hearing other heart diseases, so it is better to see a doctor more often.

Children may experience abnormal chord disease. It's not like that terrible problem. A baby with accessory chord disease can be completely healthy and live for many years. Often this disease does not remind you of itself. There is no need to panic about this disease.

The main thing is to follow the correct daily routine and see a specialist regularly. It must be remembered that additional chordae are not considered diseases. Many doctors consider an additional chord in a child to be a normal deviation from the norm.

When discovered extra chord in the baby's heart, many parents cannot keep calm. Fathers and mothers frantically begin to look for hospitals, stand in line for a consultation with pediatric cardiologist. In parallel with this, parents begin to independently familiarize themselves with the disease.

At the same time, parents constantly tug at their child. Instead of the baby fully developing and playing with his peers, parents constantly take him to doctors and clinics. The child is tortured with various tests and diagnostics. But is this disease worth the extra worry?

What is a chord for?

Heart valves are necessary for the functioning of blood flow. Thanks to them, there is no mixing of arterial and venous blood. When the next pulsation of the heart valve occurs, it bends slightly, but does not open. This way the blood is contained. In order for this valve movement to occur, special mechanisms in the heart are used, called the notochord. In the human heart there are a number of chords, which are made up of muscle tissue.

If the chord has a high density, then it is better visible on ultrasound than the other chords.

The chordae found in the human body are divided into 2 categories:

Hemodynamics are not important.
Hemodynamics matter.
The notochord, in which hemodynamics does not matter, does not harm a person.
The second type requires specialized monitoring by a doctor.

What types of chords are there?

If an extra chord is found in a child, then it does not make itself known. She is found randomly when examined by a doctor. False chord is considered by doctors genetic disease , it is often inherited from the mother. The anomaly does not affect the functionality of the body. Doctors can only help by systematically examining the patient twice a year.

Thus, the development of pathological conditions is predetermined. The notochord originates in different chambers of the heart or ventricles. A large number of chords is located in the valve of the left ventricle. Chords have different directions:

Transverse.
Oblong.
Diagonal.

Doctors have noted cases where the anomaly has changed its location. Eighty percent of patients have a single chord and approximately 20% of others have multiple chords.

Why does pathology form?

The main reason why a chord is formed is considered to be a genetic factor. As a rule, the patient's mother suffered from cardiovascular disease. Therefore, her child has a risk of developing pathology. An anomaly can also form due to the influence unstable natural situation.

Another reason may be a connection with mutagenic sources, which include tobacco toxins and drugs.

The cause of the child's illness can be alcohol consumption during pregnancy.

Symptoms

A disease developing in the heart does not remind the patient of itself. The patient has been walking around with this pathology all his life, but he has no symptoms. Doctors suspect a pathology, When does a baby have an ultrasound? for the presence of systomic murmur. As a rule, the diagnosis is made in newborns or during early development. This includes a group of children under 3 years of age.

Doctors carry out statistics on how common the anomaly is. The disease is explained by recently introduced diagnostic and treatment standards. According to these requirements, every newborn must undergo an ECHO-CG at 1 month. When a pathology is detected, parents immediately report this disease. If a child develops intensively, then pathology in the heart may be noticed. Because with accelerated development, the load on children's body increases. In this case, the little patient feels the following:

Slight tingling in the heart.
Cardiopalmus.
Weakness.
Increased fatigue.
Psycho-emotional lability.
Dizziness.

It may also differ for the child. violation heart rate from normal. These signs are typical for teenagers suffering from the anomaly. If a person is found to have many chorts, then the doctor takes into account their location to the connective tissue. That is why signs can appear in other organs of the human body.

If in a person's heart An anomaly was detected by ultrasound, then the doctor has reason to assume that the connective tissue is not developing well in the body. Next, the doctor prescribes further examination for the patient by a cardiologist and pediatrician. Based on the analyzes obtained, the specialist can conclude: the anomaly is self-sufficient or it was formed as a result of damage to the connective tissue.

If the diagnosis is made based on the first sign, then the anomaly has no symptoms. In the second case, the anomaly is associated with other organs. In this case, the patient is prescribed a comprehensive diagnosis and observation 2 times a year by a specialist.

How is the disease treated?

The anomaly does not require treatment with drugs. Medicines are prescribed if the patient is diagnosed with Clinical signs additional chord. The patient is also scheduled for observation by a cardiologist and an ECG.

Medications are prescribed if the patient exhibits symptoms that are related to cardiovascular function.

To ensure that the heart muscles are enriched with nutrients, the doctor prescribes the following vitamins:

Riboflavin.
A nicotinic acid.

These vitamins must be taken one course for a month. Such prophylaxis is prescribed 2 times a year. In order to normalize repolarization processes that have been disrupted due to abnormal heart rhythms, specialists prescribe medications with potassium and magnesium. This includes medications:

Magne B6. This drug must be taken once a month. It has contraindications for children under 6 years of age.
Magnerot, in a different way The drug is called "magnesium Orotate". This medication is prescribed in a course of 3–4 weeks. The drug is contraindicated for children under 18 years of age.
Potassium Orotate. It must be used for 3 or 5 weeks. This medication can be used for children. The dosage is prescribed by the therapist.
Panangin. This drug contains potassium and magnesium. It must be used within 1 month. In extreme cases, it is prescribed to children.

In order for the myocardial tissues to increase metabolic processes, the following antioxidants are prescribed:

Cytochrome.
Ubiquinone.
Carnitine.

If symptoms of neurocirculatory dystonia are identified, the therapist prescribes medicinal nootropics. These include Piracetam and Nootropil. Treatment of anomalies must necessarily be accompanied by preventive and general health measures. These include:

Hardening the body.
Balanced diet.
Use eat only healthy foods.
The patient needs to spend a lot of time outdoors.
You need to alternate rest with work.

A person who has been affected by an abnormality physical activity should be distributed Right. If the patient plans to take up gymnastics or dancing, then before doing so he should consult with his doctor. If a baby with a transverse chord is experiencing a disturbance in the rhythm of the heart or life - a dangerous condition, the child is urgently hospitalized. The baby will be examined in a special cardiology hospital.

Next, the patient will undergo the necessary examination and treatment will be prescribed. In rare cases, the false chord captures sections of the myocardial pathways. In this case, the patient is required to undergo surgery using the cryodestruction method. The operation is performed by cold destruction or excision.

Bottom line

Excess chorda disease does not pose a danger to life. If a child is diagnosed with a similar disease, then parents do not need to show unnecessary anxiety and panic. Chords are different.

According to the direction, the following are distinguished: transverse, diagonal and oblong. Some patients notice a change in the location of the chord. Common cause The origin of the disease is considered to be genetics.

Other causes of the disease: improper natural environment, during pregnancy the mother used tobacco or drugs. For a newborn at 1 month of age, doctors are required to prescribe an ultrasound of the heart. This procedure helps to exclude pathologies of cardio-vascular system. Diagnosis of the anomaly is as follows:

The doctor listens to the child.
If there is an extra chord in the body, then the cardiologist hears a heart murmur.
If an anomaly is detected, then the small patient is required to undergo a heart ultrasound.

As a rule, the baby does not need to use medications. If a disease is detected, the child needs to have an ECG and ultrasound of the heart twice a year.

The human heart is a complex organ. IN general scheme it consists of two atria and two ventricles. The heart performs the function of “pumping” blood around the clock and continuously, which is why it is so important to monitor your health, as well as normal functioning heart muscle, then it will work for a long time and will not bring diseases and discomfort to the body.

An anomaly in the structure of the heart cavity, in which an additional chord is formed, is most often diagnosed in the left ventricle. The notochord is an inclusion that is similar in structure to a muscle and also has a tendon. The additional chord is congenital and, as a rule, does not require special treatment.

An accessory chord of the left ventricle is diagnosed based on the results of cardiac ultrasound. This pathology is an autosomal disease associated with a dominant course. An anomaly of this type is classified as small. According to doctors, it does not require treatment and may even be normal to some extent. The danger is posed by an additional chord in the right ventricle of the heart. In the case of such a pathology, treatment and constant monitoring by a specialist is required.

Additional chord in a child - what is it?

The specificity of the formation of this pathology is associated with a failure in the formation and development of the connective tissue of the heart muscle during pregnancy. Thus, during the embryonic period of heart development in a child, the muscle is pierced by several threads.

IN in good condition The notochord in children is a muscle that connects the sides of the left ventricle of the heart. With abnormal development, additional chords with an atypical structure appear.
The older the child gets, the less influence additional chords have on his lifestyle. Gradually the heart grows and the abnormal formations shift.

Identified additional chords of the left ventricle in newborns require constant patronage during the first six months of the child’s life, then until the child is one and a half years old, the child is registered with a cardiologist. Then the heart undergoes control examinations at the ages of 3 and 7 years, when it becomes necessary to determine the health group before entering kindergarten and school, respectively.

Reasons for education

The vast majority of cases of the appearance of an additional chord of the left ventricle are a hereditary predisposition. The pathology is transmitted through the maternal line. For this reason, if a woman knows about her anomaly in the development of the heart cavity, then after the birth of the child she needs to worry about additional examination of the child to study the functioning of the heart.

Many experts agree that there are a number of factors that can provoke the formation of such an anomaly during pregnancy:

bad habits, especially smoking;
difficult environmental situation;
stress;
unbalanced or insufficient nutrition;
intrauterine infections;
weak the immune system mother.

The action of these factors can lead to pathological changes during the formation of not only the fetal heart, but also other organs and systems, therefore the expectant mother must take care in advance to exclude them as much as possible.

Diagnostics

Directly at the appointment, the doctor conducts a conversation, visual examination and listens to the heart. Some experts argue that if there is an additional chord of the left ventricle, you can hear specific noises. However, only ultrasound can give the true picture. Even an experienced doctor must first give a referral for an ultrasound examination, and only based on its results make a diagnosis and prescribe treatment.

Carrying out ultrasound in children has a number of its own characteristics. Only from the age of 6 can one count on the child’s adequate perception of the examination situation. Therefore, one of the parents or close people accompanies the child to the ultrasound. The office must be equipped with toys and take into account the age characteristics of patients. Small children, and especially newborns, should not take off all their clothes; it is enough to expose the chest to access the required area.

Modern ultrasound examination includes 2 procedures. The first is called echocardiography. With its help, you can examine the structure of the heart with maximum accuracy and characterize hemodynamics. In addition, echocardiography allows you to calculate indicators of most cardiac functions. The second cardiac ultrasound procedure is a Doppler study of intracardiac hemodynamics.

Today, cardiac ultrasound is performed in two-dimensional space, which makes it possible to assess dynamic changes in real time. Ideally, the test is performed with the patient lying on his back. However, in the case of small children, this is difficult to achieve, so you can put the child on his right side, stand him up or sit him down. The main thing is to achieve a calm position, but do not forget about subsequent correction of the results depending on the examination position.

The examination is carried out through the anterior wall of the chest, on the left side of the sternum. In this area the heart is as open as possible. The installation of the sensor depends on the age of the child; the younger it is, the higher the device is installed. In the case of newborns, the sensor can be installed directly on the sternum. To identify an additional chord of the left ventricle, a four-chamber position is usually used, in which abnormal areas appear as linear formations.

Additional chord, which is visible in the image

The examination procedure, as well as interpretation of the results, takes about 40 minutes. Ultrasound of the heart allows you to assess the condition of the chambers, the size, as well as the integrity of the organ and its structures, the characteristics of blood circulation, the specifics of the pericardial sac and the characteristics of the fluid. All indicators are significant. They may indicate not only the presence of an abnormal appearance of an additional chord, but also accompanying illnesses hearts.

Consequences

The symptoms of the disease are quite scarce. For many years, a person may not know about the presence of such a pathology. As a rule, signs of an additional chord of the left ventricle appear if its location interferes with the functioning of the heart or the pathology is multiple. So the main symptoms of the anomaly are reduced to the following manifestations:

fast fatiguability;
attacks of dizziness up to fainting;
pain of varying intensity in the heart area;
tachycardia;
heart rhythm disturbances;
frequent mood swings.

Particular attention should be paid to arrhythmia. If it occurs, you will need to undergo additional examinations. If the heart rhythm disturbances are associated only with an additional chord, then the diagnosis may sound like “hemodynamically insignificant,” but the causes may be more serious and require a different level of treatment. In general, the prognosis of the disease is favorable and, with proper treatment, it can reduce harm to health to a minimum.

Prevention and treatment

Additional pathological chord of the left ventricle, as a rule, does not require drug treatment in the traditional sense. In such a situation, the doctor can only prescribe a regular visit to a specialist, and an ultrasound of the heart to monitor the dynamics of possible changes.

If the patient is bothered by unpleasant symptoms from the cardiovascular system, then the following may be prescribed:

vitamin therapy, mainly with B vitamins;
magnesium and potassium preparations;
antioxidants;
nootropics.

Drugs are dosed according to an individual scheme and only by a specialist!

As the main measures of prevention and vital activity when making a diagnosis in general, a number of rules should be noted. If you follow them, you can maintain your well-being at the proper level and avoid possible complications:

carry out regular hardening procedures depending on the degree of preparedness of the body;
eat rationally, including as many vitamins and microelements as possible in your diet;
set aside enough time every day for walks in the fresh air (at least an hour);
maintain sleep/wake, rest/work schedules;
include feasible physical activity in your daily routine.

Modern scientists in the field medical science They have come up with several useful measures for people with the described pathology:

practice dancing in which the rhythm is quite slow;
learn and practice drill exercises;
install a wall bars and do several exercises on it;
jump rope;
run short distances;
regularly take massage courses;
take care of your psycho-emotional state.

Running render positive influence on the cardiovascular system

All these procedures have a positive effect on the cardiovascular system, and also normalize the functions of the nervous system, improve mood and generally tone the body. Preventive actions Each person is able to do it independently, but under the supervision of the attending physician. It is he who can determine the quantity and quality of physical activity and adjust the patient’s daily routine. The main recommendation is regular examination by a doctor.

Conclusion

Already on early stages During pregnancy, with the help of an ultrasound, you can hear the fetal heart beating. This vital organ is one of the first to be formed. In the prenatal state, the child is extremely susceptible to many negative factors and it is during this period that it is possible pathological development heart cavity, including the formation of a pathological chord in the left ventricle.

Today, experts classify this disease as a minor anomaly and urge not to panic when making such a diagnosis. This abnormal formation does not have a particular effect on the function of the heart and does not require specific drug treatment. However, you should constantly monitor your health, undergo an ultrasound examination and visit a specialist.

From this article you will learn about such a developmental anomaly as an additional chord in the heart of a child, and whether it occurs in adults. How serious is this, how can the disease manifest itself? Possible reasons occurrence. In what cases does it need to be treated and how to eliminate the problem.

The essence of pathology
Why does pathology occur?
Characteristic symptoms (they may not exist)
Diagnostic methods
Forecast

Additional chords (or additional chord) are an abnormal development of the heart, in which in the cavities of the ventricles there are extra constrictions (bridges) stretched between the myocardial wall and the heart valves.

Options for the location of additional chords in the heart

This anomaly is included in the group of minor cardiac anomalies, since it is more individual anatomical feature structure of the heart than pathological condition. In 90–95% of cases, it has no symptoms and does not threaten anything.

Additional chords of the heart appear in the fetus during the prenatal period and remain in the person throughout life (congenital condition). They are diagnosed only by ultrasound examination of the heart (echocardiography). In 5–10%, this anomaly can interfere with normal blood circulation, leading to arrhythmias and heart failure.

Cardiologists (adults and children), cardiac surgeons, as well as doctors deal with issues related to the diagnosis and treatment of an additional chord of the heart. ultrasound diagnostics. Treatment may not be required at all, it may involve following a gentle regimen and taking medications, or it may even require surgery. In any case, the disease is curable.

The essence of pathology

The structure of a healthy heart

The human heart consists of two atria (right and left) and their corresponding two ventricles. The tricuspid valve is located between the right atrium and the right ventricle. The left atrium is separated from the left ventricle by the mitral (bicuspid) valve. These valves are needed to allow blood to pass from the atria into the ventricles in portions, but to prevent it from being thrown back from the ventricles into the atria.

The valves are semilunar strips of connective tissue. At one end they are attached to the wall of the heart, and the other end hangs freely into the cavity of the ventricles. Between the free end of the valve and inner surface The walls of the myocardium are stretched with thin but very strong bridges in the form of threads. These bridges are called chords.

At one end, several chords, united in bundles, are attached along the perimeter of the free edge of the valve, and at the other end they are fused with muscle protrusions on the myocardium - trabeculae or papillary muscles. Each valve leaflet is approached by 2–3 bundles with chords in the longitudinal direction relative to the axis of the heart. Their purpose is to restrain the valve, give its free edge a fixed position and prevent it from moving into the atria.

Diagram of blood flow in the heart

When the atria contract, blood is expelled from them into the ventricles, and the valves open (lower) freely.

When the ventricles contract, the valve flaps begin to rise with blood flow until they come into complete contact with each other. This creates an obstacle due to which the blood does not flow back into the atria, but is thrown out into the vessels. But if there were no chords, the valve flaps would not be able to lock into the desired position at the moment of their contact. The chordae tighten the valve, like a sail or parachute, preventing it from wrapping into the cavity of the atrium.

Additional chords in the heart are the presence of excess filament bridges between the valve leaflets and the myocardium, which should not be present normally. Considering utility value chords for normal cardiac activity, there is nothing wrong with an additional chord. This is indeed true, but only if the additional chord is stretched in the same way as the other threads - longitudinally relative to the axis of the heart, and has the same thin diameter. In this case, it does not pose any danger and can be considered a variant of the norm or an individual characteristic of a particular person.

If the accessory chord is located transverse to the heart cavity or is too thick, it may:

In this case, both the child and the adult may experience signs of circulatory failure.

It is important to remember in the presence of an additional chord in the heart that this is an anomaly that may be one of the signs of congenital systemic underdevelopment of connective tissue. In such children, in addition to this anomaly, fragility and laxity of ligaments, tendons and bones, excessive mobility of joints, curvature and weakness of the spine, prolapse internal organs.

Causes of pathology

The cause of additional chordae is a violation of the intrauterine development of the fetal cardiovascular system. This failure can be caused by:

The child is born with additional chordae. They persist throughout life.

Symptoms (may or may not exist)

Does not exist specific symptoms, characteristic specifically for additional chords in the heart. Moreover, this cardiac anomaly can cause complaints and manifestations in only 5–10% of cases. The remaining 90–95% of adults and children do not make any complaints and learn about the anomaly only after ultrasound examination hearts.

If the additional chord is located transversely in the cavity of the ventricle, interferes with blood circulation or disrupts the functioning of the valves, then a child or an adult experiences:

Pain in the heart area (mainly during exercise, but can be at rest).
Frequent heartbeat (feeling of interruptions).
Fatigue and shortness of breath during exercise.
Dizziness.
Heart rhythm disturbances (paroxysmal tachycardia and extrasystole).
Murmurs when listening to the heart.

Even if the additional chord is accompanied by the listed symptoms, they only slightly disrupt general state And motor activity patient (it may be difficult to perform heavy physical work). Children with this cardiac anomaly grow and develop without any abnormalities. Most often, manifestations arise and intensify during periods of active growth and puberty.

If a child or adult has severe symptoms of heart damage ( severe pain, shortness of breath with light exertion, severe rhythm disturbances, edema) and upon examination an additional chord is discovered - do not think that it is this that causes them. Such a patient should be comprehensively examined to exclude other cardiac pathologies. An additional chord may not cause such serious manifestations, but can be combined with any diseases and anomalies.

Diagnostic methods

It is impossible to detect additional chords in the heart based on complaints and during a routine medical examination. There is only one reliable method diagnostics - ultrasound examination of the heart (echocardiography or ultrasound of the heart).

According to existing standards, this study should be performed on all newborns in the first month of life. The method is safe and reliable. Therefore, all children and adults with an abnormal chord in the heart should undergo cardiac ultrasound at least once a year. Advanced diagnostics include electrocardiography (ECG), blood pressure measurement, Holter monitoring, and stress tests.

A special device takes and records ECG throughout the day

All of these diagnostic tests cannot detect additional chords of the heart, but they determine functional abilities this organ.

Treatment (not always necessary)

If additional chords do not appear in any way, treatment is not required. It may be indicated if a child or adult has symptoms of cardiac dysfunction. For help, contact a cardiologist.

Treatment can take place at home (outpatient), and if symptoms are severe, in a cardiology hospital. The treatment program includes the following:

Forecast

About 90% of children and adults with an additional chord in the heart lead a normal life, since this anomaly does not affect its quality or duration. The remaining 10% require mild or moderate restrictions on physical activity and undergo courses of treatment periodically (1–2 times a year). Complications and life-threatening conditions occur in no more than 1% of patients.

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An additional chord in the heart is a pathology that is quite common and is not dangerous. The usual chord is a muscle that connects the opposite sides of the left ventricle of the heart, and the additional chord is superfluous and has an atypical structure. Most often it is located in the left ventricle, very rarely in the right.

Doctors for a long time studied this anomaly and ultimately came to the conclusion that it does not affect the functioning of the heart and does not pose any danger to life.

Most often, a chord in the heart is found in a child, less often in adults. This happens because in a small child’s heart its noises are easier to hear.

There are no symptoms of chord in the heart. Most often, it is discovered by chance, since when listening to the heart, noises come from it. A cardiologist who hears such a heart murmur is obliged to give a referral for an ECG, which will determine the presence of a chord. But this may also turn out to be a so-called false chord in a child, that is, heart murmurs, which most often appear precisely because of it, have another reason.

Additional chord in the heart - reasons

The cause of an additional chord in a child is exclusively maternal inheritance. Perhaps the mother also has this anomaly or simply some kind of heart disease.

Additional chord in the heart - treatment

Since there is no danger in the chord, it does not require special treatment, but you still need to follow a gentle regimen.

Abnormal chordae in children should not be a problem and should not be considered some kind of terrible disease. A child with an additional chord can be completely healthy and live to old age without even knowing what heart problems are. The main thing is not to panic, but to follow the regime and regularly see a doctor. And remember that an additional chord is not considered a disease and many doctors even recognized it, so to speak, as a normal deviation from the norm.

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Introduction

Additional chord in a child - what is it?

In normal condition, the notochord in children is a muscle that connects the sides of the left ventricle of the heart. With abnormal development, additional chords with an atypical structure appear.
The older the child gets, the less influence additional chords have on his lifestyle. Gradually the heart grows and the abnormal formations shift.

Reasons for education

Many experts agree that there are a number of factors that can provoke the formation of such an anomaly during pregnancy:

bad habits, especially smoking;
difficult environmental situation;
stress;
unbalanced or insufficient nutrition;
intrauterine infections;
weak maternal immune system.

The action of these factors can lead to pathological changes in the formation of not only the fetal heart, but also other organs and systems, so the expectant mother must take care in advance to eliminate them as much as possible.

Diagnostics

Directly at the appointment, the doctor conducts a conversation, visual examination and listens to the heart. Some experts argue that in the presence of an additional chord of the left ventricle, specific murmurs can be heard. However, only ultrasound can give the true picture. Even an experienced doctor must first give a referral for an ultrasound examination, and only based on its results make a diagnosis and prescribe treatment.

The examination procedure, as well as interpretation of the results, takes about 40 minutes. Ultrasound of the heart allows you to assess the condition of the chambers, the size, as well as the integrity of the organ and its structures, the characteristics of blood circulation, the specifics of the pericardial sac and the characteristics of the fluid. All indicators are significant. They may indicate not just the presence of an abnormal appearance of an additional chord, but also concomitant heart diseases.

Consequences

fast fatiguability;
attacks of dizziness up to fainting;
pain of varying intensity in the heart area;
tachycardia;
heart rhythm disturbances;
frequent mood swings.

Particular attention should be paid to arrhythmia. If it occurs, you will need to undergo additional examinations. If the heart rhythm disturbances are associated only with an additional chord, then the diagnosis may sound like “hemodynamically insignificant,” but the causes may be more serious and require a different level of treatment. In general, the prognosis of the disease is favorable and, with proper treatment, it can reduce harm to health to a minimum.

Prevention and treatment

If the patient is bothered by unpleasant symptoms from the cardiovascular system, then the following may be prescribed:

vitamin therapy, mainly with B vitamins;
magnesium and potassium preparations;
antioxidants;
nootropic drugs.

Drugs are dosed according to an individual scheme and only by a specialist!

carry out regular hardening procedures depending on the degree of preparedness of the body;
eat rationally, including as many vitamins and microelements as possible in your diet;
set aside enough time every day for walks in the fresh air (at least an hour);
maintain sleep/wake, rest/work schedules;
include feasible physical activity in your daily routine.

Modern scientists in the field of medical science have developed several useful measures for people with the described pathology:

practice dancing in which the rhythm is quite slow;
learn and practice drill exercises;
install a wall bars and do several exercises on it;
jump rope;
run short distances;
regularly take massage courses;
take care of your psycho-emotional state.

All these procedures have a positive effect on the cardiovascular system, and also normalize the functions of the nervous system, improve mood and generally tone the body. Each person is able to take preventive measures independently, but under the supervision of the attending physician. It is he who can determine the quantity and quality of physical activity and adjust the patient’s daily routine. The main recommendation is regular examination by a doctor.

Conclusion

Already in the early stages of pregnancy, using an ultrasound, you can hear the fetal heart beating. This vital organ is one of the first to be formed. In the prenatal state, the child is extremely susceptible to many negative factors, and it is during this period that pathological development of the heart cavity is possible, including the formation of a pathological chord in the left ventricle.

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The heart of a child and an adult: structural features

This organ has 4 chambers - the left and right atrium and, accordingly, the left and right ventricle.

Normally, blood circulates from the atria to the ventricles. The movement of blood in one direction is regulated by the heart valves, which close/open according to heart contractions.

The mobility and flexibility of the valves is provided by peculiar springs - tendon threads - chords. The latter alternately contract, stretching the valve and allowing blood to flow to the ventricle, and then relax, their valves close and the blood is not thrown back.

However, it increasingly happens that during intrauterine development one or several additional (false) chords are formed in the organ.

They are a connective tissue formation. It is worth noting that most often the false chord is localized in the left ventricle of the child’s heart. In the vast majority of cases, these formations do not lead to an increase in hemodynamic load, that is, they do not impair cardiac function. In medicine, such a disease is classified as a minor organ anomaly.

Chords are classified into longitudinal, transverse and diagonal depending on their location. Diagonal and longitudinal ones do not disrupt the blood flow in the organ, but transverse ones can complicate this process, creating obstacles, which, accordingly, affects the work of the myocardium - the heart muscle. In some cases, transverse filaments can provoke heart rhythm disturbances in adulthood (short PQ syndrome, SVC syndrome).

Reasons for the appearance of a chord in the heart of a child

The main provoking factors include hereditary predisposition. If
one of the parents has pathologies of the cardiovascular system, there is a high probability of developing one or more anomalies in the offspring, for example, false chordae, prolapse mitral valve, open oval window. In addition, external negative impacts, mutagenic causes (drugs, alcohol, smoking during pregnancy), especially during the formation of connective tissue, that is, 5-6 weeks after conception.

Additional (false) chord of the heart in a child: symptoms

If there is only one pathology, then there is a high probability that it will not manifest itself in any way throughout life. Doctors first suspect the presence of systolic heart murmurs during listening. It is worth noting that in the vast majority of cases, the pathology is diagnosed during the period from newborn to 3 years of age. This is exactly what this pathology also called disease of newborns.

The incidence rate is due to the fact that now all children who have reached the first month of life must undergo a planned ECHO-CG - ultrasound examination of the heart, in order to exclude birth defects development.

As children get older, during a period of intense growth of the musculoskeletal system, a delay in the development of internal organs occurs. As a result, the load on the heart increases, which is manifested by pain, increased fatigue, palpitations, weakness, dizziness, psycho-emotional instability. Rhythm disturbances are less common. Most often, these symptoms occur in adolescence and can accompany a person throughout his life.

If there is more than one false chord located in the child’s heart, then the doctor must remember that connective tissues is also found in other internal organs.

Accordingly, symptoms can also be expressed through dysfunction. In such a situation, connective tissue dysplasia occurs.

The pathology is manifested by changes in the skeleton (deformation of the limbs, impaired muscle function, scoliosis), the frame of the tracheobronchial tree, the digestive organs (diaphragm hernia, gastroesophageal reflux, deformation/bending of the gallbladder), the urinary organs (prolapse of the kidney, dilatation of the ureter or renal pelvis), etc. d. When there are multiple chords not only in the left ventricle, but also abnormalities are found in other organs, we can say that the connective tissue is poorly developed throughout the body.

We can say that only a pediatrician, cardiologist and a number of other highly specialized specialists will be able to decide whether we are talking about an independent disease or about general defeat body. If the chord is an independent pathology, then there are usually no symptoms. Otherwise, when the entire body is affected, this manifests itself in disorders of other organs and systems. Such children must be examined very carefully and comprehensively.

How is an accessory chord diagnosed?

Detection of the disease involves several procedures:

Clinical examination, including auscultation (listening) of the child. In the presence of pathology
systolic murmurs are heard;
ECHO-CG - ultrasound examination of the heart - the most effective method examinations;
If necessary, an ECG is prescribed, which can be performed with or without exercise to exclude heart rhythm disturbances;
Daily ECG monitoring;
Bicycle ergometry – stress tests.

How is false chord treated?

If nothing bothers the child, there is no need for drug therapy. You just need to periodically visit a cardiologist and undergo an ultrasound examination and ECG at least once a year.

Otherwise, when unpleasant symptoms occur, it is necessary to prescribe appropriate medications:

To improve the nutrition of the heart muscle, vitamins B1, B2 (riboflavin), PP ( a nicotinic acid), lipoic acid. Vitamin therapy is carried out in courses that last at least a month. In addition, such drugs should be taken at least 2 times a year;
To improve the processes electrical impulse in the myocardium, magnesium and
potassium. For example, Magne B6 (a combination of magnesium citrate and vitamin B6) is taken in a course of one month, but the drug is contraindicated before the age of 6. After reaching 18 years of age, Magnerot (magnesium orotate) can be prescribed, which is taken for 3-4 weeks. Potassium orotate is taken according to the age-specific dosage for 3-5 weeks. "Panangin" is prescribed for a whole month, but its safety for children has not been proven;
To improve metabolic processes in cells, antioxidants are required: Cytochrome C, L-carnitine preparations and similar ones;
If signs of neurocirculatory dystonia occur, nootropic drugs are required, for example, Nootropil, Piracetam.

Be sure to strengthen the body as part of the treatment complex, as well as for prevention purposes.
Parents of newborn children with such an anomaly must make efforts to prevent the pathology from making itself felt. To do this, you need to harden yourself, eat rationally and balancedly, often be in the fresh air, maintain a regime of activity and rest, and play sports (gymnastics, dancing).

If, with multiple lesions or a transverse chord, any disorders develop in the ventricle (eg paroxysmal tachycardia, atrial fibrillation, extrasystole, various syndromes, etc.) that may threaten life, hospitalization is required. In the hospital, more thorough and comprehensive examination and, based on its results, begin treatment.

Heart threshold in a newborn

To understand what the notochord is and what its functions are, you need to have an idea of the structure of the heart. This main organ human body consists of four chambers - two atria and ventricles. Provided the heart is functioning properly and there are no abnormalities in its structure, blood from the atria is pumped into the ventricles through special valves. That is, the organ works like a pump. Blood always moves in one direction due to the rhythmic closing and opening of the valves. The mobility and flexibility of the latter is provided by tendon threads, which stretch and compress according to the cycle of heart contractions. These peculiar “springs” are chords.

At normal structure There is one chord between the valves of the heart. But often in people, especially in infants, additional tendon threads are detected in the cavity of the ventricles.

Accessory chords are nothing more than additional connective tissue structures related to minor anomalies in the development of the main organ .

The presence of such a defect has virtually no effect on the activity of the heart, but patients with such a deviation are still recommended to be regularly examined by a specialist.

Types of chords

The formations in question in the ventricles of the heart are divided into several types, depending on the nature of their location. The following chords are distinguished:

Longitudinal.
Diagonal.
Transverse.

Longitudinal And diagonal are considered hemodynamically insignificant, since they do not interfere with blood flow and do not interfere with the functioning of the heart. Transverse they are considered hemodynamically significant due to the fact that they are capable of blocking the path of blood flow and disrupting the functioning of the organ. In rare cases, it is transverse connective tissue formations that become a risk factor for the development of arrhythmia. Over time, such anomalies become the cause of Wolff-Parkinson-White syndrome and shortened PQ syndrome.

Accessory chords, as a rule, appear in the cavity of the left ventricle (95%) and much less often in the right ventricle (5%). In addition, excess tendon threads can form in different departments ventricles, taking into account which they are classified into:

apical;
middle;
basal.

There may be one additional chord in the heart (single) - such a deviation is found in more than 60% of patients with an abnormal structure of the organ. Also, several valve springs can form (multiple chords), which is observed in more than 30% of people.

Etiology

The main reason for the formation of a defect in the heart cavity is a genetic predisposition .

In other words, etiological factor heredity appears. The anomaly is transmitted from mother to child and quite often women are not aware of the existence of additional chordae. The risk of developing abnormalities in the structure of the child’s heart increases if the mother has diseases of the cardiovascular system. In addition to accessory valve muscles, other abnormalities can also be detected - mitral valve prolapse, open oval window.

An equally significant factor of adverse influence, against the background of which an extra chord may form in the heart, is an incorrect lifestyle. We are talking, in particular, about the abuse bad habits. If the expectant mother smokes and uses alcoholic drinks During pregnancy, when connective tissue is formed in the fetus, we should expect that the newborn will be diagnosed with abnormal defects in the structure of the heart!

Symptoms

An accessory chord in the heart is more often found in children, and the only sign of its presence is characteristic noises that only a doctor can hear when listening. At the age of 6 years and older, the presence of an anomaly may have a slight effect on the child’s well-being, which manifests itself in fatigue and decreased physical endurance.

Diagnosis and treatment

Additional muscle formations in the cavity of the heart muscle can be identified using careful computer diagnostics. Treatment of a defect in the development of the organ is required only in cases of the formation of several chords, which can adversely affect cardiac activity. The main directions of therapy are:

classes physical therapy;
nutrition correction;
strict control over work and rest schedules;
maintaining the functioning of the nervous system;
treatment of chronic diseases.

To prevent health complications, people with this heart anomaly are advised to monitor their diet and daily routine!

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What causes it to appear?

Doctors note the main reason why this pathology occurs is a genetic predisposition. As a rule, diseases of the mother's cardiovascular system affect. The appearance of such an anomaly in a child is often observed if the mother also has it.

Of course, the child may also develop an additional chord due to the incorrect lifestyle of the pregnant woman. For example, drinking alcohol, drugs, smoking, proper nutrition etc.

These factors especially influence the development of cardiac pathologies at 5-6 weeks of pregnancy. At this time, connective tissues are formed in the embryo. But a chord can also form in later stages. We can conclude that the correct lifestyle of the expectant mother is the key to good health of the child.

Kinds

There are 2 main types of additional abnormal chords: insignificant for the hemodynamics of the heart and hemodynamically significant.

Insignificant tendon threads are divided depending on their location into:

vertical;
diagonal.

These types are not dangerous for the functioning of the heart, since they do not interfere with the movement of blood flow.

As for the hemodynamically significant ones, they include chords of the transverse type. This is a rather dangerous condition that requires constant monitoring by a cardiologist.

This formation can prevent blood from moving in the cavities of the heart and thereby disrupt the general condition of the organ and its functioning. Such a disorder in children can cause arrhythmia and other pathologies.

As the child grows, the type of chord may change, that is, its location changes.

An additional chord is also distinguished depending on the number of formations. Namely:

single (developed in 70% of patients);
multiple (according to statistics, appear in 30% of all patients).

Is this pathology dangerous?

When a child is diagnosed with an additional chord of the heart, then, as a rule, parents begin to panic and drive him around possible doctors. There is no need to do this, as this is not a disease. But there are different types this anomaly.

In case of insignificant ones, doctors recommend simply establishing a correct and regular daily routine for the child, a healthy balanced diet etc., and in case of significant anomalies you should be under the supervision of a cardiologist, sometimes you need to take medications.

If a child has only one false chord of the heart, then cardiologists do not consider this a pathology, but rather a normal deviation. The chord in the area of the right ventricle is examined more carefully.

A false chord in the heart can pass without a trace for the child, or may develop into a cardiovascular disease in the future. Typically, the first signs begin to appear during adolescence. Heart rhythm disturbances and aching pain may occur.

Already an adult with such an anomaly is susceptible to tachycardia, arrhythmia, etc. It should be remembered that this does not occur in everyone. Even if this pathology does not cause any discomfort to the child, he should be regularly examined by a cardiologist.

Diagnostics

Methods for diagnosing false chord in children are:

A child needs to undergo echocardiography 1-2 times a year. Together with an examination by a cardiologist to exclude or prevent the occurrence of other diseases.

Treatment

As a rule, no special treatment methods are used for children. Doctors recommend simply following a daily routine. Proper nutrition is also important, which will enrich the body useful microelements and vitamins. Non-drug treatment is also massage and hardening.

As for physical activity, the child, of course, needs it, but it should be moderate. It is important that the child does not experience overwork, both physical, mental and emotional.

Of course, it is not recommended to engage in professional sports, since it involves heavy loads on the body. For children with an additional chord, a wall bars can be installed.

In some cases, quiet physical therapy is prescribed. In all activities, it is important to alternate between rest and work. A child with this diagnosis should avoid nervous stress, shocks, etc.

Drug therapy for false chord of the heart in children may consist of taking magnesium-containing drugs, as well as vitamins B and PP.

Other drugs may be prescribed, which are carefully selected by the doctor according to the patient’s age. All these drugs are prescribed for use only by those who have complaints and symptoms of the presence of additional connecting threads.

As you can see, a false chord of the heart in a child is an anomaly in which it is impossible to predict the state of health in the future. For example, it may not manifest itself in any way, and the person will not feel any discomfort throughout his life.

But with this anomaly there may also be structural changes that lead to heart diseases in the future and require medicinal treatment. According to medical practice, complications are extremely rare.

This change is often diagnosed in children from birth to 3 years of age. Since now almost all newborns at the age of 1 month are prescribed a heart ultrasound. They do this because quite a lot of children today have various pathologies hearts already from birth.

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Causes

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

A pediatrician may suspect a disease in a child during a routine examination and examination of the child, paying attention to a systolic murmur during cardiac auscultation.

In most cases, the additional chord of the left ventricle does not bear any functional load on the heart and does not interfere with it normal operation. Long years this minor anomaly may not be detected because it is not accompanied by 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;
pain in the heart area;
heart rhythm disturbances.

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.

If symptoms appear, the child must be prescribed ECHO-CG, ECG and daily monitoring according to Holter. 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 needs dispensary observation at the 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 left ventricular chord may become a factor that contributes to the development of other heart and vascular diseases ( infective endocarditis, cardiac rhythm and conduction disturbances, thrombophlebitis, 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

The main method for diagnosing the accessory chord of the left ventricle is echocardiography.

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 regime;
Healthy food;
engage in physical therapy;
to harden;
often be in the fresh air;
prevent stress;
ensure proper sleep;
refuse heavy physical activity;
not to accept 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 above recommendations and more stringent restrictions in 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:

paroxysmal tachycardia;
atrial fibrillation;
Wolff-Parkinson-White syndrome;
Morgagni-Adams-Stokes syndrome;
extrasystole.

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:

Eat properly.
Stop smoking, drinking alcohol and drugs.
Avoid heavy physical activity.
Prevent stress.
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 timely treatment chronic diseases which may 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.

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The essence of pathology

An additional chord in the heart does not count serious illness. As already mentioned, thanks to modern methods of studying the heart, a chord in the heart of a child is diagnosed in the very first days of his life. For your information: just recently, about 40 years ago, an additional chord was discovered only after autopsy.

Although an additional chord in the left ventricle is not considered a dangerous anomaly, unlike the right one, its treatment is nevertheless necessary to avoid the possibility of various diseases further:

Changes in heart rhythm and, as a result, blood flow speed.
Possible endocardial damage.
Fibrosis may develop.
The biomechanics of the heart may be impaired.
Ventricular relaxation is impaired.

Improper development of connective tissue can cause minor heart abnormalities; the tissue may be weak or formed in the wrong place. Because of this, anomalies develop in children.

Symptoms

Most often, only one thread of the chord is formed. In this case, she does not manifest herself at all. It can be detected in the womb using an ultrasound examination of the heart. Thus, there is no need to fear that it will not appear in the first years of the child’s life; it will definitely be seen during a routine examination of the pregnant mother. Whether there are symptoms in this case or not is irrelevant.

At the age of 10 to 15 years, when the child is growing rapidly but unevenly, that is, the limbs and spine are growing, but the heart is still small, childish, quite noticeable symptoms may occur:

Frequent pain in the heart area.
The child feels his heartbeat.
Increased fatigue.
Causeless weakness.
Vegetative-vascular dystonia appears.

If there is multiple chordae in the heart, this means that excess connective tissue develops throughout the body. Accordingly, other manifestations of it are observed in various organs:

Noticeable changes in the skeleton, scoliosis, curvature of the limbs.
Bend of the gallbladder.
A hiatal hernia may occur.
The contents of the stomach are thrown back into the esophagus.
Dilation of the ureters and renal pelvis.
Kidney prolapse.

Thus, excess connective tissue develops not only in the heart, but also in other internal organs.

Treatment

So, the reasons for the occurrence of chord are considered. Diagnosis is, as a rule, a mandatory ultrasound of the heart and an electrocardiogram subsequently.

If in the case of one chord the patient has no symptomatic manifestations, then drug treatment it makes no sense. If several chords are diagnosed, then there are several stages of treatment:

In order for the heart muscle, myocardium, to work better and more correctly, a course of at least a month of taking vitamins B1, B2 and nicotinic acid is prescribed.
To eliminate cardiac arrhythmia, that is, to improve the conductivity of the heart muscle, a course of magnesium with vitamin B6, potassium, Panangin is prescribed. All medications are prescribed in courses, the duration of which depends on the age of the child.
To improve metabolism in the heart muscle, a course of antioxidants is necessary.
If a nerve conduction disorder occurs, a course of appropriate medications is prescribed.

In any case, the course of treatment and medications is prescribed only by a cardiologist after thorough examination and carrying out analyzes taking into account the individual characteristics of the patient: his age and the speed of development of the body.

There is also non-drug treatment, which is also prescribed by the doctor:

Measures to harden the body.
Adequate diet with plenty of vitamins.
Long walks. Trips to nature, fresh air.
Regular exercise. Of course, in each individual case, a specific sport is prescribed that corresponds to the child’s condition.

Possible complications

It is impossible to say with certainty regarding complications, but in general modern medicine copes successfully with excess chordae, that is, with the consequences of formation in the heart.

Of course, the child must be constantly monitored by a cardiologist and follow all the doctor’s instructions, both in terms of medication, diet and exercise. Following all the recommendations will ultimately help you live full life, without symptoms of the presence of an extra chord.
Chronic heart failure treatment 1st degree prolapse