Eventually the chain tensioners wear out and changing a chain is enough work that I usually scrap the car at that point. Belts are much easier to change, and perhaps more importantly, inspect.
None of them have had issues with the chain or the tensioner.
That could be a testament to old Japanese engines (specifically Nissan) though, two from 1996 and one from 1982.
You end up with a choice between sounding like it's broken and having to spend a good chunk of a weekend dismantling it.
Unlucky, it skips a bunch of teeth and bends all the exhaust valves. I managed to salvage one of those too by driving around at high rpm until the valves had...Hammered themselves mostly straight again. Wouldn't recommend, usually you'll get an iffy cylinder or two after that that mysteriously only fire above 2000 rpm