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Chest X-rays: Helping detect heart and lung conditions If a picture is worth a thousand words, the images from a chest X-ray can be invaluable in detecting problems with your heart or lungs. When you go to the emergency room with chest pain, for instance, a chest X-ray (radiograph) can help determine whether you may have heart failure or a collapsed lung. Chest X-rays can reveal fluid in the lungs, enlargement of the heart, pneumonia and many other conditions — they're not just for detecting a broken rib or two. How the procedure helps youDespite the numerous high-tech imaging procedures now available, the basic chest X-ray remains a core tool in helping diagnose problems with your cardiovascular and pulmonary systems — your heart, lungs and blood vessels. Chest X-rays are painless, quick and relatively inexpensive. Your doctor may advise you to have a chest X-ray if you have a persistent cough, an injury involving your chest or difficulty breathing. And, after a physical examination and medical history, a chest X-ray is often among the first procedures you'll undergo if your doctor suspects you have heart or lung disease. Among the features a chest X-ray shows:
A heart that isn't pumping efficiently may be enlarged, for instance, and even changed in shape. Among the conditions these changes might point to are heart valve defects, including mitral regurgitation, mitral stenosis and aortic stenosis. The appearance of your heart on the X-ray can help determine what condition may be to blame. X-rays can also help detect such conditions as heart failure, congenital heart disease and fluid around the heart (pericardial effusion).
How the test is done
An X-ray machine produces a tiny burst of radiation that passes through your body and produces an image on a film or a digital recording device. X-rays penetrate body structures and tissue in different ways. For instance, bone is very dense and blocks much of the radiation, so the image on the film appears white. Your heart also blocks some of the radiation and so appears as a lighter area on the film. Lungs, on the other hand, are filled with air, so they block little of the radiation, creating a dark image. Chest X-rays can be done by an X-ray technician or radiologist in a hospital radiology department or in a clinic. You'll probably be required to undress from the waist up and wear an exam gown. Remove jewelry from the waist up, too, since both clothing and jewelry can interfere with the X-ray and obscure the images. Tell your doctor or technician if you might be pregnant. You can have an X-ray even if you have a pacemaker or defibrillator. In fact, an X-ray can help determine if the devices are where they should be and whether they've sustained any mechanical damage. During the procedure, your body is positioned between the X-ray camera and the X-ray film. You may be asked to move into different positions or angles in order to take views from both the front and the side of your chest. During the front view, you stand against the plate that contains the X-ray film. You hold your arms up or to the sides and roll your shoulders forward. You will have to take a deep breath and hold it for a few seconds while the X-ray image is taken. Holding your breath after inhaling helps your lungs and heart show up more clearly on the image. During the side view, you turn and place one shoulder on the plate and raise your hands over your head. Again, you will take a deep breath and hold it during the filming process. The amount of radiation in any X-ray is low. Still, you may wear a protective lead-lined apron during the process. A radiologist — a doctor trained in X-rays and other imaging exams — or other doctor analyzes the images, looking for clues that may suggest you have heart failure, fluid around your heart, a congenital heart defect or another condition.
Limits of the testAs useful as chest X-rays are in detecting problems with your cardiovascular system, they're generally just one step in the process of making a diagnosis. Not all conditions, for instance, can be detected by X-ray. And even if the X-ray does suggest an abnormality, you may need to undergo a variety of other tests or procedures to help confirm a diagnosis, such as a magnetic resonance imaging scan, computerized tomography scan or an ultrasound. You may also need to have a series of X-rays over time to monitor your condition and evaluate changes.
Dry Skin (xerosis)
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The size and outline of your
heart. Chest X-rays can reveal the size and shape of your heart, which offer clues about its health. Abnormal changes may indicate a variety of diseases. 
