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[False chorda tendinea of the left ventricle: possibility of diagnosis with echocardiography]
Insights
Echocardiography identified false tendons, anomalous fibrous strings in the left ventricle, in 4 of 1500 patients. These findings aid in differentiating cardiac structures and diagnosing conditions.
Area of Science:
- Cardiology
- Medical Imaging
- Anatomy
Background:
- False tendons are endocardial fibrous structures in the ventricle, not connected to atrioventricular valves.
- Historically identified during autopsy, recent advances allow echocardiographic visualization.
- Understanding their echocardiographic appearance is crucial for differential diagnosis.
Observation:
- Four cases of left ventricular false tendons were identified in 1500 patients via echocardiography.
- These anomalous string-like echoes spanned from the interventricular septum to the apex or lateral wall.
- Associated conditions included mitral valve prolapse, hypertension, and arrhythmias.
Findings:
- Echocardiography revealed false tendons as linear echoes throughout the cardiac cycle.
- These structures can be mistaken for other abnormalities like septal hypertrophy or subaortic stenosis.
- Bidimensional echocardiography aids in distinguishing false tendons from other intracardiac masses.
Implications:
- Accurate echocardiographic identification of false tendons is essential for correct diagnosis.
- Distinguishing false tendons prevents misdiagnosis of more serious cardiac conditions.
- Further research is needed to refine echocardiographic diagnostic criteria for false tendons.
Abstract:
False tendons are fibrous strings that originate from the ventricular endocardium, but do not insert into the atrioventricular valve leaflets. Until recently these structures were recognized only at autopsy: recent reports have described some echocardiographic features of false tendons. In this paper we report our experience about false tendons in the left ventricle and some considerations on the echocardiographic differential diagnosis of these structures. In 4 of 1500 consecutive patients evaluated by M-mode and bidimensional echocardiography we have observed, throughout the cardiac cycle, an anomalous string-like linear echo stretched from the upper part of the interventricular septum to the apex (two cases) or to the lateral wall of the left ventricle (two cases). Associated cardiovascular diseases included mitral valve prolapse in two cases, systemic arterial hypertension in two cases and disturbances of cardiac rhythm in one case. Abnormal echoes in the left ventricular outflow tract are a common finding in several disorders such as discrete subaortic stenosis and aortic valve prolapse or vegetations. Furthermore a false tendon running parallel to the interventricular septum can mimick septal hypertrophy. Bidimensional echocardiographic examination, can identify these different conditions. Further studies will be necessary to firmly establish the diagnostic criteria of these structures at echocardiography.