Anomalous chordae tendinae. A source of echocardiographic confusion.

A unique instance of an anomalous chorda tendinae visualized in the left ventricular outflow tract during M-Mode and two-dimensional echocardiography, and subsequently confirmed during surgery for concomitant severe rheumatic valvular disease, is described. The M-Mode appearance can be confused with more serious forms of heart disease manifesting extraneous echoes in the outflow tract, and an approach to these echoes is described, based on a review of the literature.