Incidence and distribution of left ventricular false tendons: an autopsy study of 483 normal human hearts

The incidence and distribution of left ventricular false tendons were studied in a series of 483 autopsy specimens of human hearts from subjects evenly distributed by sex and age. False tendons were observed in 265 specimens (55%), and their incidence was greater in hearts from male than from female subjects (61 versus 49%; p less than 0.01). Neither the incidence nor the location of false tendons varied appreciably with age. Of the 265 specimens containing false tendons, 100 (38%) exhibited 2 or more, such that the total number of false tendons identified was 414. Of these 414, 272 (66%) were located between the posteromedial papillary muscle and the ventricular septum, 49 (12%) between the two papillary muscles, 47 (11%) between the anterolateral papillary muscle and the ventricular septum, 38 (9%) between the free wall and the septum and 3 (less than 1%) between two aspects of the free wall; 5 (1%) had three or more points of insertion and formed weblike structures. False tendons are common anatomic variants of the normal human left ventricle which may be detected by two-dimensional echocardiography and should not be misinterpreted as pathologic structures such as flail mitral chordae tendineae or mural thrombi.