In addition to the tendon cords that normally connect the papillary muscle to the mitral leaflet, other fibrous structures are attached to other parts of the left ventricular cavity. They are called left ventricular pseudotendinous cords. Most of them are dense fibrous tissue, and a few are composed of endocardium-encapsulated myocardium, and their number varies from single to multiple. Two-dimensional echocardiography has now become the method of choice for the diagnosis of left ventricular pseudotendinous cords. For almost a century, left ventricular pseudotendinous cords were generally considered to be an anatomical variant without clinical significance. In recent years, it has been suggested that left ventricular pseudotendinous cords may be associated with cardiac murmurs, arrhythmias, and chest pain, chest tightness, and palpitations. The presence of left ventricular pseudotendinous cords predisposes to the development of premature ventricular contractions, but does not cause the development of malignant ventricular prematureities that are at high risk. Because of the high excitability of the myocardial strips, they may also be excited by the diastolic involvement of the ventricles, leading to sinus tachycardia. Some patients have palpitations and chest tightness without evidence of cardiac disorders other than pseudotendinous cords found on ultrasound, and clinical symptoms may resolve with symptomatic treatment. Those with pseudotendinous cords may also have no clinical symptoms, but may also have chest pain, chest tightness, and palpitations. Patients with chest pain, chest tightness, palpitations and other symptoms should be considered clinically if they are related to left ventricular pseudotendinosis. Patients with less severe symptoms may not be treated urgently and should be examined further. In conclusion, although pseudotendinous is not a disease, it is easily confused with certain diseases. With the popular use of echocardiography and the increase of detection rate, it is no longer considered as an anatomical variation without clinical significance, but one of the causes of heart murmurs, arrhythmias and chest pain, chest tightness and palpitations. Most of them do not require treatment. For those with tachycardia, frequent premature beats and obvious symptoms, anti-arrhythmic drugs such as betalactone can be applied.