Why do you need a chord in the heart. Additional (false) chord in the heart of a child

What types of chords are known
What is the cause of occurrence?
What are the symptoms of having an extra chord?
Possible ways of treatment and prevention

The notochord in the heart is the tissue that connects the opposite walls of the left ventricle of the heart. This tissue resembles normal muscle in appearance. If there is one or more chords in the heart, then this is already an abnormal development of the structure of the body. To this day, there is no exact confirmation that the chord in the heart can cause great harm to human health. Experts believe that this chord is not responsible for performing any functions, and since there is no negative effect, the patient does not need treatment. Although constant monitoring by a doctor is required, because due to the presence of a chord in the heart, extraneous noises occur in it.

What types of chords are known

Chords in the heart can be localized in different parts of it. It is this fact that makes it possible to distinguish several species, classifying them according to different principles.

Classification according to location.

Location in different chambers of the heart:

Chords are left ventricular (the majority of such species).
Right ventricular chords (very rare).

Location in different parts of the ventricles:

Classification of chords according to their direction:

Diagonally arranged chords.
Longitudinally located chords.
The chords are transverse.

Classification of chords by number:

Single chords.
Chords are multiple.

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What is the cause of occurrence?

An additional chord in the heart can only occur for a single reason - this is a hereditary factor. This disease can be transmitted only along the line from the mother of the child. Very often, the mother may be unaware that she has this disease. Although any other heart disease in a mother can provoke the formation of an additional chord in a child. No other reasons were identified. But the influence of some factors, which include the unfavorable environment of the external environment, an unhealthy lifestyle and the presence of bad habits in the mother during pregnancy, can negatively affect.

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What are the symptoms of having an extra chord?

An additional chord in the heart does not manifest itself in any way, and you can find out about its presence only through an ultrasound examination, to which a cardiologist can send, having heard a suspicious noise in the area of \u200b\u200bthe heart.

In most cases, this disease manifests itself in childhood. Doctors explain this fact by the fact that with growing up there is an increase in the volume of the heart, due to which the chord can shift. In a child, the reason for contacting a cardiologist is a sharp decrease in endurance and increased fatigue during high physical exertion.

These symptoms may lead the doctor to suspect that the child has an extra chord in the heart.

It is possible to determine the presence of an additional chord only through computer diagnostics. Today, children at the age of one month are carried out, which is included in the routine examination of the child, which allows to exclude the development of possible pathologies and establish the correct development and formation of the body. Therefore, parents most often learn about the presence of a chord during the period of early development of the child.

In adolescence and in adulthood, people with an additional chord may experience pain in the region of the heart, they may feel an increased heartbeat, they may feel excessive fatigue, weakness, dizziness.

In the case when there is more than one chord, then we are no longer talking about an independent disease of the chord, but about the connective tissue itself, which is located not only in the heart, but also in other organs. In the case when the anomaly is the result of damage to the connective tissue, the symptoms will manifest themselves in the development of other organs. Additional monitoring, complex examinations of the whole organism will be required.

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Possible ways of treatment and prevention

The study of this disease in a patient is carried out through a comprehensive examination, which allows you to identify the presence of the disease and its complexity:

Examination by a cardiologist. This is where the examination process begins. In the process of listening, the doctor will definitely hear a heart murmur and, based on this, will prescribe additional examinations.
Cardiogram (simple and with a load).
Daily monitoring.
load tests.

A detailed study of the studies carried out will help the doctor to draw a conclusion about the type of chord, its quantity and the danger that it carries or does not carry to the human body. Most often, doctors assure parents that this disease is very common among children and it does not pose a danger to the child's later life. They put the child under control, making a note that the noises heard refer to the presence of a chord in the heart.

Despite the fact that a chord in the heart is absolutely not a dangerous disease, the presence of many chords can lead to a violation in the heart rhythm, which will result in difficulties in transferring physical exercises and stress.

An abnormal chord in the heart is not cured by simple drugs. But you should not forget about health in any case. On the contrary, the patient must remember the risk stage, do not forget about prevention, taking care of observing the daily routine, adhering to proper rational nutrition.

And although most experts do not consider the presence of an additional chord to be any deviation, it is still impossible to forget about its presence, because any heart disease carries a negative risk factor for human health and life.

In cases where the patient experiences discomfort and the above symptoms of the presence of a chord appear, doctors prescribe medication.

To provide additional nutrition to the heart muscle, groups of vitamins are used. Vitamins are selected and prescribed by a doctor. Their application is carried out by the course.
To normalize the processes of repolarization, preparations with a high content of potassium and magnesium are used, which are also used in a certain course in accordance with the prescribed doctor's regimen.
Antioxidants are used to improve metabolic processes in cells.

Despite the fact that vitamins are mainly prescribed drugs, their use without the knowledge of a doctor is categorically contraindicated. The doctor selects drugs in accordance with individual indicators, medical history, symptoms and many other factors. In any case, doctors advise their patients not to dwell on the disease, but to lead a normal life without overexertion of the body.

It is important to find a middle ground that will allow you to lead an active lifestyle without unnecessary restrictions.

An additional chord found in a child during routine examinations causes anxiety in most parents. But it’s better not to panic, but to learn more about whether an extra chord is dangerous and how its presence can threaten a child’s health.

Any anomaly in the development of the child, and even more so his heart, causes anxiety and worries in parents

What is this

To better understand what an additional chord is, you need to remember the anatomical structure of the heart and the features of its functioning. If this organ is working normally, then the blood moves in it from the atria to the ventricles. This movement is regulated by special valves, the opening of which occurs due to the contraction of thin tendons located in the ventricles, called chords. When they are relaxed, the valve leaflets are closed, and as soon as the chords contract, the valves tighten, their leaflets open slightly and blood passes into the ventricles.

Although some parents think that normally a child should have two chords in the heart, and the third chord in the child's heart is additional, in fact there are more chords in the ventricles, but normally they all have the same structure and the same thickness. If atypical chords are found among the tendons, attached to the wall of the ventricle from only one end, they are referred to as additional. Such formations do not participate in the opening of the valves, therefore they are also called false or abnormal.

What is the correct structure of the heart and how it should ideally work can be seen in the next video.

Causes

The appearance of an extra chord occurs during the laying of the heart during fetal development. The main reason for this deviation is called genetic predisposition. Most often, education is transmitted through the maternal line (in 90% of cases), but it can also be transmitted from the father. Other factors provoking the appearance of an extra chord are:

Smoking or drinking alcohol in the first trimester.
Bad environmental situation.
Insufficient or unbalanced nutrition.
Infections during pregnancy.
Stress in pregnancy.
Weak immunity of the expectant mother.

Kinds

An accessory chord can be detected in any ventricle, but in 95% of cases it is a chord of the left ventricle of the heart in a child, which is abbreviated as LVLC. Only in 5% of babies with an extra chord, it is located in the right ventricle.

The anomaly is single in 70% of detection, and in 30% of children, additional chords are represented by multiple formations. In its direction, the extra chord can be transverse, diagonal or longitudinal. If we take into account the localization inside the ventricle, then the chord is referred to as basal, median or apical formations.

In addition, all chords are divided into 2 types:

Hemodynamically insignificant. Such formations are referred to as a variant of the norm, since they do not affect the blood flow. Most often, these are single strands in the left ventricle.
Hemodynamically significant. Such chords affect blood flow and can cause problems with the work of the heart.

Symptoms

If in the left ventricle of the child there are chords in a single amount, often he will not have any manifestations. When the anomaly is located in the right ventricle or in the presence of multiple chords, parents will notice the following signs:

Fast fatiguability.
Frequent pulse.
Weakness.
Decreased stamina.
The appearance of dizziness.
Complaints of tingling in the heart.
Lability of the psycho-emotional state.
Arrhythmias.

Children with an additional chord in the right ventricle get tired faster from mental and physical activity

Note that a newborn with an extra chord often feels well, and in most cases, clinical symptoms appear at school or adolescence, when the child is growing very quickly.

Diagnostics

In most cases, an additional chord, as well as LLC, is detected during a planned ultrasound of the heart. Such an examination takes place every baby in 1 month. If the pediatrician hears murmurs in the baby's heart, he can send the baby for echocardiography earlier. To check the work of the heart with an additional chord, children are also prescribed an ECG, and in order to identify hidden problems with the rhythm, bicycle ergometry and Holter monitoring are performed in adolescence.

Children with an additional chord in the heart are regularly prescribed an ECG

Consequences

For most babies, the presence of additional chords, especially if it is LVH, does not pose any danger and does not interfere in life. Sometimes such formations "resolve" themselves - the heart increases in size and the chord is displaced, becoming inaccessible for visualization with ultrasound.

Some chords that affect blood flow can cause problems with heart function, such as conduction disturbances and arrhythmias. In rare cases, a chord without treatment leads to the appearance of ischemic stroke, endocarditis, thrombophlebitis and other pathologies.

If the chord in the heart is one of the symptoms of underdevelopment of the connective tissue, such a pathology will also be manifested by high growth, thin physique, joint hypermobility, bone deformities, problems in the gastrointestinal tract and kidneys.

Treatment

Drug therapy is prescribed for children with an extra chord only with clinical manifestations of the problem, for example, if the child complains of discomfort in the chest. Also, drug treatment must be prescribed when rhythm disturbances are detected. In rare cases, when the false chord includes the conduction paths of the heart, it is excised or destroyed by cold.

Children with an additional chord are observed by a cardiologist and are regularly examined

Among the medicines that are prescribed with an additional chord, there are B vitamins, potassium orotate, magne B6, panangin, magnerot, l-carnitine, actovegin, ubiquinone, piracetam and others. They normalize metabolic processes in the tissues of the heart, improve the conduction of impulses and nourish the heart muscle.

In addition, a child with an extra chord is advised to provide:

Balanced diet.
Daily recharge.
Frequent walks.
hardening.
Minimum stress.
Optimal daily routine.
Timely treatment of diseases.

Such children are not prohibited from outdoor games and moderate physical activity, such as swimming, gymnastics or running.

The opinion of Dr. Komarovsky

A popular pediatrician confirms that an extra chord in the heart, especially LVH in a child, is not dangerous in most cases. In his practice, he has repeatedly seen children in whom the chord detected during ultrasound was only a statement of fact, but it did not cause any inconvenience or problems to the child, and did not manifest itself outwardly.

Komarovsky emphasizes that in most cases such children do not need treatment and their lifestyle is not required. The only thing that a well-known doctor of parents warns about is that grown children with an extra chord should not work as divers or skydive.

For information on what to do with pain in the heart, see the program of Dr. Komarovsky.

An additional chord in the heart of a child or adult found during diagnosis is not a severe deviation. It is perceived as a minor anomaly, rarely leading to complications. To understand the features of the pathology will help the causative factors and probable symptoms that manifest themselves in case of failures in hemodynamics (blood flow). Treatment is prescribed only in the presence of clinical manifestations and an increased risk of complications.

Chords are tendon threads of the same thickness and size, consisting of muscle and connective tissues and connecting the valvular apparatus and the ventricle. When they contract, they pull the valve leaflets towards themselves, which contributes to the formation of a gap and the release of blood from the atria. During relaxation, the passage is closed. The additional (false) chord does not perform its intended functions. It has an atypical structure and can be connected to the ventricle or valve with only one end.

The abnormal chord has an ICD code (International Classification of Diseases) 10 revision Q20.9. It stands for "Congenital Anomalies of the Heart Chambers". In the role of an independent pathological process, the "falsh chord" is not considered. It is divided according to its location in the heart cavities as follows:

Towards:
- transverse;
- diagonal;
- longitudinal.
By location in departments:
- right ventricular;
- left ventricular.
Depending on quantity:
- single;
- multiple.
Location in the stomach:
- basal;
- apical;
- median.

An extra chord in the heart usually does not pose a particular danger, but whether this is so depends on the hemodynamic significance. Transverse tendon filaments can disrupt the flow of blood, leading to various consequences (stroke, arrhythmias, heart block). Multiple chords are no less dangerous, as they are perceived as a sign of genetic pathologies.

In most cases, a left ventricular single filament is detected in newborns during an ultrasound examination of the heart. Sometimes it is noticed in the fetus in the womb during routine diagnostics. In adults, its detection is associated with a medical examination or the occurrence of cardiac symptoms.

False tendon threads in infants are often combined with other small anomalies in the structure of the heart:

extra trabecula;
open oval window;
valvular insufficiency.

Unlike other anomalies, the open foramen ovale closes with age. Only in rare cases does it stay forever.

A well-known pediatrician, Komarovsky E. O., commented on the presence of "falshhord" in babies. According to the expert, the baby will not experience any discomfort. This anomaly is rather an individual feature than a serious defect. Only in exceptional cases, in the presence of many tendon filaments, manifestations of hemodynamic failures are possible. Treatment will be aimed at stabilizing the work of the heart. Single chords do not require any therapy regimen or restrictions regarding the type of activity, sports or diet.

Causes

An additional chord in the heart of a child occurs even in the womb due to certain factors:

Cause	Description
hereditary predisposition	The presence of false tendon threads or other heart ailments in one of the parents is the main cause of anomalies in their baby.
bad habits	A woman who uses alcohol, drugs and smokes cigarettes during pregnancy significantly increases the likelihood of malformations in the unborn child, affecting not only the heart.
Bad environmental situation	Polluted air and water contribute to the formation of anomalies in the baby during fetal development.

Clinical picture

One extra chord in the left ventricle rarely manifests itself. The situation is different with the transverse arrangement of the thread in the right ventricle, or if there are quite a few of them. The patient begins to experience discomfort associated with impaired hemodynamics and the work of the heart in general:

fast fatiguability;
disruptions in the heartbeat;
stitching pain in the chest;
mood swings;
general weakness;
dizziness.

Symptoms most often appear during adolescence. The child begins the stage of intensive growth of muscles and bones, which gives an additional load on the heart. If they are detected, it is necessary to register with a cardiologist so that he monitors the development of the situation and takes timely measures to stabilize the condition.

Diagnostic methods

A cardiologist should be engaged in identifying extra chords and drawing up a treatment regimen. They are detected using instrumental diagnostic methods and by auscultation (listening to noises):

Ultrasound examination (ultrasound) allows you to visualize the structure of the heart and consider the features of hemodynamics.
Auscultation helps to hear diastolic murmurs arising from an additional chord.
Electrocardiography (ECG) displays the electrical activity of the heart and allows you to see possible violations of the conduction of the impulse.

Additionally, the doctor may prescribe daily ECG monitoring and bicycle ergometry. The first examination helps to obtain accurate data on the work of the heart muscle throughout the day. The second test is conducted to evaluate her response to physical activity.

The identified extra chord in the child's heart may gradually "disappear". The baby is actively growing, which leads to a displacement of the anomaly. Instrumental diagnostic methods will confirm its absence. There will be no treatment plan. In conclusion, the doctor will indicate that the heart is without pathologies.

Course of therapy

In the absence of symptoms of disruptions in the blood flow, the anomaly does not make sense to treat. A person will have to undergo an ultrasound and ECG every year and, with the results, sign up for a visit to a cardiologist in order to monitor the condition of the heart muscle.

If the clinical picture of a violation in hemodynamics is still present, then drug therapy is prescribed:

Preparations rich in B vitamins (Neurovitan, Superum) are involved in nervous regulation, increase cellular metabolism and stop the development of atherosclerosis.
Tablets containing magnesium and potassium ("Asparkam", "Orokamag") help to stabilize pressure, vascular tone and neuromuscular transmission.
Antioxidants ("q-Protect", "Resveratrol") prevent the development of atherosclerosis, normalize the work of the heart and stimulate metabolic processes in the myocardium.
Medications with nootropic action ("Aniracetam", "Semax") are used to improve cognitive abilities and increase tolerance to stress (physical, mental). They are also used to relieve signs of VVD against the background of severe disruptions in hemodynamics.

Antiarrhythmic and other cardiac medications are prescribed by the attending physician, depending on the patient's condition. As an addition to the treatment regimen, you should follow the rules of a healthy lifestyle:

With the development of various life-threatening conditions, the patient must be hospitalized. Usually they are the result of multiple or transverse additional chords. In a hospital setting, a detailed examination will be carried out and treatment will be prescribed.

Surgical intervention is required if the accessory tendon filament impairs impulse conduction and results in severe interruptions in blood flow. Doctors will perform the procedure of cryodestruction (destruction of tissues by exposure to cold) or excision of the notochord.

The likelihood of complications

It is impossible to predict in advance whether an additional chord will lead to the development of malfunctions in the heart, or not.

The most favorable prognosis is in the presence of an anomaly in the left ventricle.

In most cases, it does not lead to pathological changes and does not require treatment. The use of medications to improve the functioning of the heart muscle significantly reduces the likelihood of complications. It is worth fearing only transverse and multiple tendon filaments. They have the worst prognosis.

Military service

In the presence of a single false chord, young people who have reached the age of 18 are still drafted into the army to serve. Representatives of the medical commission believe that it will not have any effect on well-being during the next year of life. The conscript is not required to undergo treatment in a hospital. He will be quite able to follow orders and engage in physical training on a par with other military personnel. A contraindication to service in the armed forces is a failure in the heart rhythm and other severe complications caused by the anomaly.

Extra chords in the ventricles of the heart muscle are perceived by specialists as a minor anomaly that does not require treatment and does not limit human life. It is enough to do an ultrasound every year to monitor its development. If there are signs of failures in hemodynamics and arrhythmia, drug therapy is prescribed. If with its help it is not possible to achieve an endowment of the state, then surgical intervention will be required.

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Symptoms and causes of an open foramen ovale in the heart
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The heart is an organ whose functional purpose is to pump blood and ensure its circulation throughout the body. The main trigger mechanism for transporting blood through the vessels is the heart muscle, which, in turn, activates the valves that allow the inlet and outlet of blood.

Carefully examining the structure of the heart, one can notice fairly strong tendon threads that hold the valves, not allowing them to sag. These "threads" in medicine are called chords.

If the doctor visualizes one chord attached to the valve leaflet, no anomalies are involved. If there is an additional chord in the heart valve, cardiologists declare the anatomical features of the structure of the heart. At the same time, doctors do not sound the alarm, since the extra chord is not considered from the perspective of a pathological anomaly.

Additional chord - what is it

The human heart is characterized by a four-chamber structure, in which two ventricles are symmetrically located relative to the two atria. The chords pull the valves towards themselves, allowing the blood to move. As soon as the chords weaken, the valve closes, preventing the blood from returning back.

However, in some cases, additional chords can be determined in the heart, which do not participate at all in the process of pumping blood. It is for this reason that they are called not only additional, but also false chords in the heart. What it is - most modern people misunderstand, respectively, they panic, only after hearing such a diagnosis, without understanding the specific situation. Parents are especially anxious when pediatricians and cardiologists confidently declare an abnormal chord in the baby's heart. Parents strive to get the maximum amount of useful information, based on which it would be possible to figure out whether an additional chord is dangerous, what treatment should be carried out.

By the way, even four decades ago, false chords were determined during an autopsy. Throughout their lives, such people did not complain at all about their health, did not experience any unpleasant symptoms from the cardiovascular system.

At present, due to the rapid development of the diagnostic branch of medicine, the emergence of new unique diagnostic equipment, doctors can easily identify a false chord, assess the possible risk that may accompany it, and also determine how much treatment is necessary.

Patients who are "pleased" with such a diagnosis should by no means fall into despair. First of all, they should visit a cardiologist, who will not only tell how many chords are in a person’s heart, but also tell where the abnormal chord is located, what problems it can provoke under certain circumstances later.

Quite often, cardiologists inform patients that such abnormal chords are not capable of causing functional failures, which means that a person can live with them all his life without experiencing any problems. In such cases, no treatment is carried out, patients are only recommended to undergo periodic preventive examinations.

Causes of pathological formation

At the moment, an additional chord is determined more often in the heart of a child. Often pediatricians, listening to the heartbeat, notice. To establish what provokes such noises, the baby is sent for diagnostics, during which it is possible to visualize the abnormal chord.

An additional chord is formed during fetal development. The main reasons considered are:

hereditary factor (if either mom or dad also has such a chord);
an unfavorable factor (if during pregnancy the mother abused alcohol, smoked, used toxic substances, was exposed to chronic or infectious diseases);
genetic factor (when chromosomes and genes have undergone a pathological mutation).

The following can also affect the occurrence of an abnormal chord:

malnutrition (when foods with an excessive content of animal fat are eaten);
heavy loads (when a pregnant woman has to carry heavy objects);
living in an area characterized by an increased level of pollution;
frequent stay of a pregnant woman in stressful situations;
decrease in immunity.

Doctors, having carefully studied the history and diagnostic results, will be able to inform patients why an extra chord has formed, what are the main reasons for such an abnormal feature.

Symptoms of the pathological phenomenon

It is possible to suspect the presence of an abnormal chord in the heart only if some external signs begin to appear. In other cases, the abnormal structure is determined not only in a child, but also in an adult during an ultrasound examination.

If the child began to complain about the rapid onset of fatigue, the parents began to notice that the child's endurance level had decreased excessively, it is important not to speculate theoretically what caused such changes, but to go to the hospital for medical help.

Adult patients often complain of pain that occurs in the region of the heart. They also experience headaches, observe their heart palpitations. If such symptoms occur, it is recommended to consult a cardiologist.

Diagnosis and treatment

Unfortunately, in the age of information technology, free access to various Internet resources can play a “cruel” joke when, by identifying certain symptoms, a person rejects the need to visit a clinic, and develops a self-treatment scheme for himself. This is an addiction that can provoke extremely undesirable consequences. Unfortunately, too late seeking medical help reduces the level of effectiveness of both drug therapy and surgical treatment.

Examination for suspected additional chord

To identify an extra chord in the child's heart, the doctor carefully listens to heart rhythms with a stethoscope. If such an abnormal structure is observed, the doctor will definitely hear extraneous noises.

In this case, the pediatrician collects information regarding the general well-being of the baby, his level of mobility, endurance. If the suspicion is confirmed by the listed symptoms, the patient is referred for instrumental diagnostics:

(not only the presence of an anomalous chord is determined, but also its location is visualized, it is specified to which category it belongs);
blood pressure tracking;
conducting an ECG after exercise;
Holter monitoring.

As a result of a comprehensive diagnostic examination, it is possible not only to identify extra chords of the heart, but also to establish the level of functioning of the heart.

Treatment of the disease

The cardiologist can offer parents only to bring the child for preventive examinations, while no special treatment is prescribed. Indeed, such an approach is possible if the second (extra) chord does not adversely affect the functioning of the heart.

If the cardiologist observes even the slightest negative effect of the abnormal chord on the performance of the heart muscle, he prescribes medication that involves taking:

vitamins;
metabolic drugs;
beta-blockers for palpitations;
with increased swelling;
nootropic drugs for the normalization of the nervous system.

In dangerous situations, a decision may be made to perform a surgical operation involving the removal of an abnormal chord. Such surgical intervention is carried out in the case when the chord provokes a dangerous failure of the normal distribution of blood or severe cardiac arrhythmias.

Cardiologists may recommend using alternative therapy. In particular, it is quite useful to take a handful of raisins on an empty stomach. This "breakfast" helps to strengthen the heart. Valerian, peppermint, calendula flowers normalize the heart rate. Only alternative treatment should also be agreed with the attending physician, manifestations of amateur performance are not allowed.

Possible Complications

If the patient refuses to visit the clinic, resorts to self-treatment, his general well-being will definitely not improve, but, on the contrary, his health may be seriously shaken.

Fortunately, such complications are not common, doctors confirm that only 1% of patients have to experience additional problems due to lack of treatment or its incorrect implementation.

So, if therapy is not carried out when diagnosing a false chord, the failure of the heart rhythm is aggravated, followed by:

pulmonary embolism;
ischemia;

In the most dangerous situations, death can follow, especially if ventricular fibrillation is observed. It is for this reason that it is necessary to proceed to high-quality treatment, which is carried out by a cardiologist.

Forecast and prevention

The prognosis of the patient's condition when a chord of the left ventricle of the heart is detected in him is favorable in most cases. In particular, 90% of patients with such an anomaly lead a normal life.

It is possible to prevent the occurrence of any complications, troubles, if you follow the recommendations of doctors:

observe proper nutrition;
carry out hardening procedures;
plan and strictly observe the daily routine;
do ;
take walks in the fresh air;
give up bad habits;
avoid stressful situations;
allow only physical activity with the recommended level of intensity;
perform therapeutic massages.

So, an extra chord is not considered a dangerous disease if the patient follows the recommendations of doctors. In such cases, a person throughout his life may not encounter unpleasant symptoms, allow himself to lead a normal life, without limiting himself in various activities.

Tendon chords, or tendinous filaments in the cavity of the left ventricle, are connective tissue formations represented by a thin fiber attached on the one hand to the fleshy trabeculae in the wall of the left ventricle, and to the leaflets of the mitral or bicuspid valve, on the other.

The function of these threads is to provide a connective tissue frame inside the heart and to support the valve leaflets to prevent it from sagging into the cavity of the left ventricle (LV). When the myocardium of the ventricle relaxes, the chords stretch, the valve opens, passing a portion of blood from the atrium to the ventricle at the time of diastole (relaxation) of the latter. When the myocardium of the ventricle contracts, the chords, like springs, relax, and the valve leaflets close, preventing the reverse flow of blood into the atrium and contributing to the correct ejection of a portion of blood into the aorta at the time of systole (contraction) of the ventricle.

chords and trabeculae in the structure of the heart

Sometimes, in the period of intrauterine development, for various reasons, not several chords are laid, as usual, but one or more additional threads.

If both ends of the thread are fixed, we are talking about a true chord, and if one end is not attached to the valve leaflet, but sags freely in the cavity of the left ventricle, we speak of a false additional or additional chord of the left ventricle.

As a rule, there is one additional chord, less often there are multiple ones. In relation to the longitudinal axis of the left ventricle, longitudinal, diagonal and transverse chords are distinguished. In most cases, such formations do not adversely affect blood flow through the chambers of the heart, therefore, they are considered hemodynamically insignificant formations. However, in the case of a transverse location of the ectopic (that is, in the wrong place) chord relative to the cavity of the left ventricle, its presence can provoke cardiac arrhythmias by type.

Recently, the frequency of registration of additional chords in the heart has increased, mainly due to an increase in the number of those performed in the neonatal period, according to the new standards for examining children under the age of one month. That is, clinically, such chords do not appear, and if the child had not undergone echocardioscopy, the parents might not know that the child has an abnormally located chord in the heart.

Diagnosis of “additional trabecula of the left ventricle” in the lexicon of doctors of ultrasound diagnostics, it is actually equivalent to the concept of an additional chord. Although, as mentioned above, from the point of view of anatomy, the trabecula is a separate entity that continues the chord.

Causes

Accessory chords are classified as minor anomalies of heart development (MARS)- these are conditions that occur in the prenatal period in the fetus and are represented by a violation of the structure of the internal structures of the heart. In addition to the additional chord, MARS also includes.

The development of an additional chord is primarily due to heredity, especially on the part of the mother, as well as the impact of adverse environmental conditions, bad habits of the mother, stress, malnutrition and concomitant somatic pathology of the pregnant woman.

The occurrence of MARS may be due to a disease such as connective tissue dysplasia is a hereditary pathology characterized by "weakness" of the connective tissue in the heart, joints, skin and ligaments. Therefore, if a child has several heart abnormalities, the doctor should rule out dysplasia.

Symptoms of an additional chord

As a rule, an additional chord does not manifest itself in any way throughout a person's life. This is observed in most cases when the anomaly is not accompanied by connective tissue dysplasia and is represented by a single thread.

If a child has several chords determined by ultrasound of the heart, which also occupy a transverse position in the heart, it is quite possible that complaints from the heart occur during periods of intensive growth of the child, as well as during puberty and pregnancy. These include weakness, fatigue with pain in the chest, accompanied by a feeling of palpitations and a feeling of lack of air, pallor. In some cases, such chords can provoke the occurrence or in the patient.

In the case when the occurrence of MARS is due to dysplasia syndrome, the corresponding symptoms are characteristic- high growth of the child, leanness, hypermobility of the joints, frequent dislocations of the joints, deformity of the spine and ribs, structural disorders in other organs (omission of the kidney, expansion of the pelvis in the kidneys, deformation of the gallbladder, bronchopulmonary dysplasia and other anomalies in their various combinations).

Diagnostics

Usually an extra chord is a "chance" find when performing echocardioscopy to a child at the age of one month or a little later. Currently, all babies at this age should undergo an ultrasound of the heart in order to identify undiagnosed immediately after birth and as a routine examination of the child. Therefore, even for the parents of a healthy baby, the doctor's conclusion about the presence of a chord in the heart can come as a complete surprise. However, in the absence of other significant pathology, such children are recognized by pediatricians as practically healthy and do not require close monitoring by a cardiologist.

If the chord in the heart is combined with another pathology of the heart and blood vessels, the child should be observed by a pediatric cardiologist. In this case, in terms of examining the baby, there will be, if necessary, an ECG with physical activity at an older age, and daily monitoring of the ECG and blood pressure in the presence of heart rhythm disturbances. For adult patients with an ectopic notochord, the follow-up plan is the same with examinations performed once a year or more often if indicated.

Is additional chord treatment required?

If an abnormal chord in the heart is found in a child, and the baby does not have other significant cardiac diseases, this condition does not need to be treated.

In the case when functional disorders of the cardiovascular system are observed at an older age, which do not cause hemodynamic disorders, develop due to the inability of the heart muscle to contract correctly, and also do not lead to, it is possible to prescribe drugs that support and nourish the myocardium. The use of potassium and magnesium preparations is justified (magnerot, magnevist, panangin, asparkam), B vitamins, antioxidants ( actovegin, mildronat, mexidol and etc). The appointment of complex vitamin preparations is also indicated.

If the patient has significant cardiac dysfunction, medications such as diuretics, antihypertensives, antiarrhythmics and other groups of drugs are indicated. Fortunately, indications for this in the case of abnormal chords in the heart are extremely rare.

Lifestyle

It is not required to follow a certain lifestyle for a child with an additional chord. A balanced diet is enough with the intake of fortified food, long walks in the fresh air, as well as normal physical activity. Restricting a child to physical education or sports does not make sense. The child can actively run, jump and perform all those physical activities that are acceptable for his age and practiced in the educational institution that he attends. Swimming, figure skating, hockey are welcome.

Regarding preventive vaccinations according to the national calendar, we can say that the additional chord of honey. is not a withdrawal, and the baby can be vaccinated according to age.

As the child grows older and enters the difficult period of puberty, it is important refusal of bad habits and adherence to the principles of a healthy lifestyle. In case of any age-related manifestations of the heart and blood vessels (sweating, fatigue, tachycardia, shortness of breath), the teenager should be shown to a cardiologist and, if necessary, drink or pierce the above-mentioned drugs.

Pregnancy for girls with an additional chord, of course, is not contraindicated. In the case of the presence of several of the congenital heart anomalies, an ultrasound of the heart during gestation and observation by a cardiologist is recommended.

Young men are not contraindicated in the army. A withdrawal from the army is the patient's development of heart failure, which, again, is rare with an additional chord.

A few words should be given to the nutrition of children and adults with structural or functional disorders in the heart. If possible, fatty, fried, salty and smoked foods should be avoided. Preference should be given to fresh vegetables and fruits, natural juices, dairy products and low-fat fish. The use of red and black caviar, dried apricots, raisins, tomatoes, carrots, bananas and potatoes, rich in substances useful for the heart muscle, is welcome. In addition, the daily diet should include cereal products, for example, various cereals for breakfast. Of course, the child should be protected from eating chips, soda from cans and various fast food dishes, as this can lead to obesity, and excess weight will adversely affect the state of the heart muscle and vascular walls in the future.