False chordae tendineae

Left ventricular false chordae tendineae is a congenital cardiac developmental abnormality and is one of the causes of premature beats and physiological heart murmurs, and it is easily misdiagnosed as organic heart disease. Left ventricular false chordae tendineae are derived from the inner myocardial layer of the primitive heart. Most are composed of dense fibrous tissue, and a few are composed of myocardium wrapped by endocardium. Their number varies, and they can be single or multiple. Currently, two-dimensional echocardiography is the preferred method for diagnosing left ventricular false chordae tendineae. For nearly a century, left ventricular false chordae tendineae were generally considered an anatomical variation of no clinical significance. In recent years, it has been believed that left ventricular false chordae tendineae may be related to heart murmurs, arrhythmias, chest pain, chest tightness, and palpitations. The false chordae tendineae hang in the left ventricular cavity. When the left ventricle contracts and rapidly ejects blood, the blood flow is obstructed by the left ventricular false chordae tendineae, generating turbulence in the left ventricle; at the same time, when the false chordae tendineae encounter accelerated blood flow, they cause the ventricular wall connected to the false chordae tendineae to vibrate together, producing a murmur. We also observed the course direction of the false chordae tendineae and found that the closer their termination is to the left ventricular outflow tract, the more obvious the murmur produced. In a few patients, the false chordae tendineae tightly pull the interventricular septum, causing the left ventricular cavity to form a "gourd" shape, which may also cause left ventricular outflow tract stenosis. Although false chordae tendineae are not a disease, they are easily confused with certain diseases. During echocardiography, multiple views should be carefully observed to help differentiate them from these diseases. With the widespread application of echocardiography and the increased detection rate, it is no longer considered an anatomical variation of no clinical significance, but rather one of the causes of heart murmurs, arrhythmias, chest pain, chest tightness, and palpitations. For those with precordial murmurs, arrhythmias, chest pain, chest tightness, and palpitations, cardiac examination should be performed to determine whether they are caused by false chordae tendineae. In short, false chordae tendineae are not a serious disease and can be reassured.