Periodic stitching pains in the heart, sensations of interruptions in his work. Who has not experienced such symptoms? Few people do not understand what is at stake. Turning the above complaints to the doctor, most often a person receives a recommendation in addition to an ECG to undergo an echocardiography.
Of course, a study may reveal a gross pathology, for example, a decrease in contractility of the walls or heart defects. But often, especially in children and young people, in conclusion they are diagnosed with an additional chord (DH). Many questions immediately arise, since the term is little known. The article will tell you what the extra chord means, about the causes of its development, about the symptoms, treatment and methods of diagnosis and prevention.
A bit of anatomy
The heart is divided into 4 chambers: 2 ventricles, 2 atria. The right chambers are divided 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 cusps of the valves mentioned above.
Normally, blood flows through the veins in the atria, then into the ventricles. During the reduction of the latter, blood must flow into the aorta and the pulmonary trunk. Valves block her return path to the atria. True chords prevent the sash from bending into the cavity of the atria, keeping them closed.
Definition
Chords are connective tissue strands attached at one end to the papillary muscle and the other to the valve leaflet. And what does “extra 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, the extra ventricular chord belongs to small developmental abnormalities. Recently, however, many experts agree on the need to revise the classification. This is mainly due to the high prevalence of diagnosis among the population.
The false chords are most often detected accidentally during medical examination and are most often found in children. If the doctor does not like the results of the ECG, or he listened to heart murmurs, the patient is sent for an echocardiographic study to determine their causes. Noises and ECG changes can be caused by dozens of different heart pathologies. And the extra chord is the most insignificant among them.
The reasons for the occurrence.
In the medical community, a genetic predisposition is considered to be the main reason for the appearance of additional chords. This developmental feature is inherited from the mother. But you should not discount external factors affecting the fetus through the body of a pregnant woman:
- smoking;
- alcohol consumption;
- taking narcotic substances;
- poor environmental conditions;
- stressful situations;
- uncontrolled medication.
It must be remembered that all of the above leads not only to the formation of additional chords, but also to much more serious consequences. These are fetal malformations that are not compatible with life or seriously impair its quality.
Classification.
False chords are divided into several categories:
- tissue structure: fibrous, muscular, fibro-muscular;
- 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.
The false chords of the left ventricle are classified in relation to other structures into 3 types:
- The thread, between the tips of the papillary muscles.
- Chord, between the apex of the papillary muscle and the wall of the ventricle.
- Less often, the chord begins from the wall of the left ventricle, and the other end is free.
Signs
The extra chord in the ventricular cavity often does not manifest itself clinically. A person does not complain about anything or even think about his health. The only thing the false chord can give itself to is systolic (in the phase of muscle contraction) heart murmur. The absence of symptoms is characteristic of relatively quiet periods of development of the child or for adults.
However, during rapid growth of the body, especially in adolescence, as well as with multiple additional chords, it can cause more significant hemodynamic changes. Heart murmur will be louder. Among the symptoms you can observe:
- general weakness;
- fatigue;
- Dizziness
- stitching pains in the heart;
- a feeling of interruption in his work;
- palpitations.
The body needs to rebuild, so there are some hemodynamic disturbances. After overcoming the described stage of development, the symptoms may disappear, rarely remain for life.
It is extremely rare that there are pathological pathways conducting impulses in the false chord. This is how life-threatening arrhythmias develop (paroxysmal tachycardia, ERW and Morgagni-Adam-Stokes syndromes).
Complications
When a person is diagnosed with a severe diagnosis, false chords can aggravate the patient's condition. For example, if infectious myocarditis initially develops on the valves, then colonies can also develop on DC. In this case, the risks of separation of vegetation (bacterial growths) increase with the subsequent entry into the general bloodstream and blockage of the arteries.
Similar processes occur with myocardial infarction. Due to reduced heart function, the rate 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 the patient always begins with an examination. Often, the diagnosis of DH is made in conjunction with connective tissue dysplasia. In this case, the patient reveals too high growth, lean physique, frequent dislocation of the joints, their increased mobility.
An important step in the diagnosis is listening to heart sounds and detecting systolic murmur. If such an important sign is found, the patient is sent for electrocardiography.
The method shows the electrical activity of the heart. ECG recording in the presence of DH can reveal various cardiac arrhythmias: from extrasystoles to paroxysmal tachycardia. If the results are uncertain, the doctor may prescribe a long-term ECG recording (Holter monitoring) or an electrocardiogram with physical activity (bicycle ergometry, treadmill test).
Without fail, a patient with heart murmur is referred for echocardiography. Ultrasound examination of the heart 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 vortices in the cavities, how the heart muscle relaxes and contracts - all this helps the doctor to judge the function of the heart, the possibility of the influence of DC on hemodynamics.
Electrophysiological research (EFI) is the last to be used. This is the most reliable way to identify the mechanisms of rhythm disturbances. It is invasive (from within the heart) and not invasive (through the esophagus). In both cases, an ECG is recorded at rest and during diagnostic stimulation.
So additional ways of carrying out which can be and in HH are revealed. All methods together give the doctor a complete picture of the disease, on the basis of which he makes a decision on the further management of the patient.
Treatment
Suppose a doctor diagnosed a patient with an "extra left ventricular chord." This means that she is alone and she should not be scared. Especially if a person does not experience any symptoms. In addition, most of the medical community considers hemodynamically insignificant false chord a normal option, and it does not require treatment. However, it is still worthwhile to observe it and undergo an ECG and ECHO-KG once a year, not more often.
If the symptoms bother the patient, then drug therapy is prescribed. It mainly has a restorative and soothing character:
- Vitamins B1, B2, B6, B12 improve the processes of nervous regulation.
- Preparations with magnesium and potassium in the composition contribute to the stabilization of vascular tone and neuromuscular transmission.
- Nootropics increase the body's resistance to physical activity, accelerate cognitive, that is, mental, 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 of premature ventricular contraction), urgent hospitalization is necessary. If such conditions are repeated, and according to the results of examinations (EFI), it turns out that the cause is the false chord, then it is necessary to consider the options for surgical treatment: cryodestruction (destruction by cold) or dissection of the additional chord.
An auxiliary method of therapy is maintaining a healthy lifestyle. In order not to think about the disease, it is enough to follow the following recommendations daily:
- walk in the fresh air in the park, outside the city for at least an hour;
- exercise regularly;
- eating vegetables and fruits;
- reduce the amount of “fast carbohydrates” eaten: sweets, bakery products;
- quitting smoking, alcohol, or narcotic drugs;
- go to bed until 22 hours, because it is until midnight that the body rests as efficiently as possible;
- duration of sleep 7-8 chat and more;
- maintain a positive attitude and smile more.
These measures are not only a treatment method, but also help prevent the development of other diseases. Performing simple tips, you can seriously improve health and forget about all the sores.
Forecast
After being diagnosed, people wonder if an extra chord is dangerous. The prognosis of the disease in the vast majority of cases is favorable, but under one important condition. A person should not feel symptoms that worsen his health. If the patient has a clinic with severe rhythm disturbances, the prognosis worsens somewhat. But in this case, the pathology is treated. The main thing is to reveal it in time.