Chordae tendineae

Heart coronal xs

Muscolopapillarex

File:UOTW 75 - Ultrasound of the Week 1.webm Chordae tendineae, often referred to as the "heart strings," are critical components of the heart's anatomy, specifically within the ventricles. They are thin, tendinous cords that connect the papillary muscles to the tricuspid valve and the mitral valve in the heart. Their primary function is to prevent the inversion or prolapse of these valves during systole (the phase of the heartbeat when the heart muscle contracts and pumps blood from the chambers into the arteries). This article delves into the structure, function, and clinical significance of the chordae tendineae.

Structure

The chordae tendineae are composed of collagenous fibers, elastic fibers, and endothelial cells. They originate from the papillary muscles, which are located in the walls of the ventricles, and attach to the cusps or leaflets of the tricuspid and mitral valves. The number and exact structure of the chordae tendineae can vary from one heart to another. They are categorized into primary, secondary, and tertiary chords based on their attachment points and function.

Function

The main function of the chordae tendineae is to stabilize the valve leaflets during ventricular contraction. By holding the leaflets in a closed position, they prevent the backflow of blood (regurgitation) into the atria when the ventricles contract. This mechanism ensures efficient blood flow through the heart and into the systemic and pulmonary circulations.

Clinical Significance

Diseases or damage to the chordae tendineae can lead to valve dysfunction, such as mitral valve prolapse (MVP) or tricuspid valve prolapse. MVP is a condition where the mitral valve leaflets bulge (prolapse) into the left atrium during systole, which can lead to mitral regurgitation. This condition can cause symptoms such as shortness of breath, palpitations, and fatigue. In severe cases, surgical repair or replacement of the valve may be necessary.

Rupture of the chordae tendineae is another serious condition, often resulting from acute myocardial infarction (heart attack) or chronic valve disease. A rupture can lead to severe valve regurgitation, requiring urgent medical intervention.

Prevention and Treatment

Preventive measures for chordae tendineae and related valve diseases include controlling risk factors such as hypertension, diabetes, and other conditions that can lead to heart disease. Regular medical check-ups are important for early detection and management of heart valve issues.

Treatment options vary depending on the severity of the condition and may include medication to manage symptoms or surgery to repair or replace the affected valve. In recent years, minimally invasive techniques have been developed for valve repair, offering patients shorter recovery times and less discomfort compared to traditional surgery.

Conclusion

The chordae tendineae play a vital role in the heart's function by ensuring the proper operation of the mitral and tricuspid valves. Understanding their structure and function is crucial for diagnosing and treating heart valve diseases. Advances in medical science continue to improve the outcomes for patients with chordae tendineae-related conditions, emphasizing the importance of ongoing research and innovation in cardiac care.

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