Periodic stabbing pains in the region of the heart, sensations of interruptions in its work. Who hasn't experienced these symptoms? Few people do not understand what is at stake. Turning to the doctor with the listed complaints, most often a person receives a recommendation, in addition to the ECG, to undergo echocardiography.
Of course, the study may reveal a gross pathology, for example, a decrease in wall contractility or heart defects. But often, especially in children and young people, in conclusion they make a diagnosis: an additional chord (EC). Many questions immediately arise, since the term is little known. The article will tell you what an additional chord means, about the reasons for its development, about 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 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, then into the ventricles. During the contraction of the latter, blood must flow into the aorta and pulmonary trunk. Valves block her returnpath to the atria. True chords prevent the leaflets from bending into the atrial cavity, keeping them closed.
Definition
Chords are connective tissue threads attached at one end to the papillary muscle, and at the other end to the valve leaflet. And what does "additional chords of the ventricle" mean? The false notochord also originates from the papillary muscle, but can attach to all structures except the valve.
All over the world, an additional chord of the ventricle refers to minor developmental anomalies. Recently, however, many experts agree on the need to revise the classification. This is mainly due to the high prevalence of the diagnosis in the population.
Falshchords are detected most often 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 the heart murmur, then 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.
Causes
In the medical community, it is generally accepted that genetic predisposition is the main reason for the appearance of additional chords. This feature of development is inherited from the mother. But external factors affecting the fetus through the body of a pregnant woman should not be discounted:
- smoking;
- drinking alcohol;
- receptiondrugs;
- poor environmental situation;
- stress 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 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;
- attachment site: basal, medial, apical.
Falshchords of the left ventricle are also classified in relation to other structures into 3 types:
- Thread, between the tops of the papillary muscles.
- Chord, between the apex of the papillary muscle and the wall of the ventricle.
- Rarely, the chord starts from the wall of the left ventricle, and the other end is free.
Signs
An additional chord in the ventricular cavity often does not manifest itself clinically. A person does not complain about anything and does not even think about his he alth. The only thing that a false chord can give itself away is systolic (in the phase of muscle contraction) heart murmur. The absence of symptoms is characteristic of relatively calm periods.child development or adult.
However, during the rapid growth of the body, especially in adolescence, as well as with multiple additional chords, it can cause more significant changes in hemodynamics. The heart murmur will be louder. Symptoms include:
- general weakness;
- fatigue;
- dizziness;
- stabbing pains in the region of the heart;
- feeling interruptions in his work;
- heartbeat increase.
The body needs to rebuild, so there are some hemodynamic disturbances. Once this stage of development has been overcome, the symptoms may disappear, rarely remain for life.
Extremely rarely in the false chord there can be pathological pathways that conduct impulses. This is how life-threatening arrhythmias (paroxysmal tachycardias, SVC and Morgagni-Adam-Stokes syndromes) develop.
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 may develop on the DC. In this case, the risks of detachment of vegetations (bacterial growths) increase with subsequent entry into the general circulation and blockage of the arteries.
Similar processes occur in myocardial infarction. Due to the reduced work of the heart, 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.
Diagnosis
ExaminationThe patient always begins with an examination. Often, the diagnosis of CD is made together with connective tissue dysplasia. In this case, the patient is found to be too tall, thin build, frequent dislocations of the joints, their increased mobility.
An important step in the diagnosis is listening to heart sounds and identifying systolic murmurs. If such an important sign is detected, the patient is sent for electrocardiography.
The method shows the electrical activity of the heart. Recording an ECG in the presence of DH can reveal various cardiac arrhythmias: from extrasystoles to paroxysmal tachycardia. If the results are doubtful, the doctor may order a long-term ECG recording (Holter monitoring) or an exercise ECG (bicycle ergometry, treadmill test).
It is mandatory for a patient with a heart murmur to be 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 eddies 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 effect of CD on hemodynamics.
Electrophysiological study (EPS) is 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 withdiagnostic stimulation.
This is how additional ways of conducting are revealed, which may be in the HH. 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
Let's say the doctor diagnosed the patient with an "extra chord of the left ventricle". This means that she is alone and you should not be afraid of her. Especially if the person is not experiencing any symptoms. In addition, 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 watching her and undergoing an ECG and ECHO-KG once a year, not more often.
If the symptoms bother the patient, then drug therapy is prescribed. It is mainly restorative and calming in nature:
- 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 stress, accelerate cognitive, that is, mental processes in the brain. Antioxidants improve heart metabolism.
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 arrhythmias (atrial fibrillation, paroxysmal tachycardia, premature ventricular contraction syndromes), urgent hospitalization is necessary. If such conditions are repeated, andaccording to the results of examinations (EPS), it turns out that the false chord is the cause of everything, then it is necessary to consider surgical treatment options: cryodestruction (cold destruction) or dissection of an additional chord.
Auxiliary method of therapy is maintaining the most he althy lifestyle. In order not to think about the disease, it is enough to follow the following recommendations daily:
- walk outdoors in the park, outside the city for at least an hour;
- exercise regularly;
- eating fruits and vegetables;
- reduce the amount of "fast carbohydrates" eaten: sweets, baked goods;
- stop smoking, alcohol, drugs;
- go to bed before 10 pm, because it is until midnight that the body rests as efficiently as possible;
- sleep duration 7-8 chat and more;
- stay positive and smile more.
The above 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 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 well-being. If the patient has a clinic of severe arrhythmias, the prognosis is somewhat worse. But even in this case, the pathology is treated. The main thing -reveal it in time.
