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An x-ray (X-ray) is a non-invasive medical test that helps doctors diagnose and treat various conditions. Images are obtained by exposing a small dose of ionizing radiation to a specific part of the body. This radiation is able to penetrate or linger in the tissues of organs, thereby making it possible to obtain pictures or screen images. X-rays are the oldest and most commonly used form of medical imaging.
A chest x-ray is a very common test. This method is used to diagnose heart diseases alone or together with other organs of the chest. It is an x-ray examination that is one of the first procedures that a patient will undergo if the doctor suspects heart or lung disease. It is also used to test the effectiveness of a treatment.
What abnormalities can be detected on an x-ray of the heart
Everyone with heart disease has an anterior and lateral chest X-ray taken. X-ray examination shows the shape and size of the heart, the outline of large blood vessels in the lungs and chest.
It is easy to see the abnormal shape and size of the heart, calcium deposits in the blood vessels, information about the condition of the lungs can be detected, in particular, whether the blood vessels are abnormal, whether there is fluid in or around them.
An x-ray will be able to detect enlargement of the heart, which is often associated with heart failure or heart valve disease. The heart does not enlarge when heart failure occurs due to constrictive pericarditis. With it, scar tissue forms in the entire sac, which envelops the heart (pericardium).
The appearance of blood vessels in the lungs is often more helpful in diagnosing heart problems than examining the heart itself. For example, dilation of the pulmonary arteries (the arteries that carry blood from the heart to the lungs) and narrowing of the arteries in lung tissue suggests high blood pressure in the pulmonary arteries, which can lead to thickening of the right ventricular muscle (the lower heart chamber that pumps blood through the pulmonary arteries to the lungs). ).
A chest x-ray can show changes or abnormalities in the lungs that result from heart problems. For example, the presence of fluid in the lungs (pulmonary edema) may be the result of congestive heart failure.
Changes in the size and shape of the heart may indicate heart failure, fluid around the heart (pericardial effusion), or problems with the heart valve.
Because X-ray images show the outline of large vessels near the heart muscle—the aorta and pulmonary arteries, and veins—physicians will be able to identify aortic aneurysms, other blood vessel problems, or congenital heart defects.
A chest x-ray can detect the presence of calcium deposits in the heart or blood vessels. Its presence may indicate damage to the heart valves, coronary arteries, heart muscle, or pericardium. Calcium deposits in the lungs most often occur after a previous infection.
A chest x-ray is useful for monitoring recovery after heart surgery. The radiologist may look at any lines or tubes that were placed during surgery to check for air leaks and fluid buildup or air buildup. Pacemakers and defibrillators have special wires attached to the heart to monitor a person’s normal heart rate.
Indications for an x-ray of the heart
An X-ray of the heart is performed with such indications:
- planned treatment of patients who suffer from ischemic heart disease;
- suspicion of presenting heart defects;
- asymptomatic, unstable angina;
- tracking conditions in the pulmonary circulation;
- asymptomatic latent diseases of the cardiovascular system;
- to detect calcification of the aortic valves, mitral valves, pericardial sac – pericardium, myocardium after acute cardiac ischemia.
Cardiologists and surgeons refer their patients for X-ray examination who complain of:
- having symptoms of angina pectoris – these are compressive pains in the chest, a feeling of lack of air, interruptions in the work of the heart, rhythm disturbance;
- shortness of breath at rest and during exertion, increased fatigue and severe weakness;
- tachycardia, arrhythmia – disturbances in the rhythm of heart contractions;
- present swelling of the lower extremities and severe pallor of the skin;
- enlarged liver;
- persistent cough and fever.
X-ray of the heart makes it possible to suspect the following pathologies in a patient:
- exudative pericarditis – infectious inflammatory lesions of the pericardium (pericardial membrane);
- abnormal increases in the size of the heart, called myocardial hypertrophy, which is found in coronary heart disease and hypertension;
- aneurysms of the walls after myocardial infarction, appear as protrusions;
- dilated cardiomyopathy – damage to the heart muscles in the form of stretching of the chambers of the heart;
- a pronounced anatomical defect in the membranes of the heart muscle, most often these are various valve defects;
- calcium deposits on the walls of the coronary artery, the presence of seals, the detection of atherosclerotic and thrombotic plaques;
- clouding, expansion of the root of the lungs, which means the possible presence of cardiac pathology.
Contraindications for X-ray of the heart
X-ray examination is contraindicated in seriously ill patients, for example, with cancer. Doctors also prohibit this diagnosis if the patient has recently received a large dose of radiation. The dose in total for the whole year should not exceed 5 millisieverts. The radiologist must indicate the received radiation dose at each diagnosis of the patient.
If the patient has not reached the age of fourteen, it is not recommended to conduct an x-ray examination of the heart. After all, the sensitivity of a young organism is several times greater and higher than that of an adult. Since the organs of the child are located close to each other, there is a high risk of irradiation of healthy internal organs.
Children are allowed to conduct an X-ray examination in case of severe urination disorders, serious dental pathologies with the threat of accumulation of pus in the oral cavity, with frequent and severe attacks of bronchial asthma. And it is strictly forbidden to do X-ray diagnostics with a negative Mantoux test.
The doctor may prescribe an x-ray of the chest, in particular the heart, in pregnant women is quite rare. Usually if there is already a suspicion of something very serious and necessary to determine the doctor’s next steps. In the first trimester, a pregnant woman is strictly prohibited from conducting x-ray diagnostics. Indeed, it is during this period that important foundations are laid for the future health of the child, the formation of the main systems and organs of the fetus is underway.
If in the following months it is necessary to conduct this study, then it is carried out in this way: the abdominal area is closed with special protection against ionizing radiation, and the strength of the X-ray radiation itself decreases.
It is interesting to consider the fact that in pregnant women the size of the heart can usually increase and the position of the heart can shift, thereby arching the arch of the pulmonary artery. This is associated with an increase in blood flow to the fetus.
During breastfeeding, there are no contraindications for this type of examination. After all, the rays do not affect breast milk, without harming the baby.
Research types
Today, the following types of surveys are used:
- Standard chest x-ray.
- Contrast X-ray, in which the esophagus is filled with a contrast agent, so that the borders of the heart are clearly visible. At the same time, five to seven milliliters of a barium-based substance is given to the patient to drink, and the boundaries of the esophagus and the left atrium are already clearly visible on the x-ray.
How to prepare for a chest x-ray
A chest x-ray does not require much preparation on the part of the patient. The person will need to remove any jewelry, glasses, piercings, or other metal on their body prior to the procedure. Because this can make it difficult to make a correct diagnosis and darken the image. Be sure to tell your doctor if you have a surgically implanted device, such as a heart valve or pacemaker. It depends on which diagnostic method can be applied in a particular case. A chest x-ray can be done when the patient has metal implants. But other scans, like an MRI, can be risky for people who have a metal device inside. Women with long hair are advised to stab them, since it is forbidden for foreign bodies to enter the diagnostic zone. When hit, the quality and information content of the x-ray image drops significantly.
Also, before the x-ray, you will need to undress to the waist and follow the instructions of the laboratory assistant. Radiography of the heart can be carried out in three types of projections. During the procedure, the laboratory assistant will ask you to hold your breath for literally 10 seconds to get clear contours of the image.
How is the research process
The X-ray image looks like a black and white image. Black color shows the places that are translucent and let X-rays through, and those areas that cannot let ionizing radiation through are highlighted in white. That is why the bones and heart muscle in the image are white.
The x-ray machine is located in a special large room with a movable x-ray camera attached to a large metal arm, the so-called shoulder. The patient should stand next to the “plate”. This plate contains X-ray film or a special sensor that records images on a computer. The laboratory assistant will tell you how to stand correctly – raise your arms and bend them at the elbows, and write in the front and side projections. Usually, the manipulation is carried out in two projections, but for a more accurate and specific diagnosis, they can be performed in three or four – anterior, lateral left, oblique left and right, at an angle of forty-five degrees. It is the pictures in the oblique projection that help to view the walls of the aortic arch, the walls of the myocardium, which are not examined in the lateral view. For example, oblique right shooting makes it possible to examine all parts of the heart.
While the images are being taken, you will need to take a deep breath and hold your breath at the request of the technologist and keep your body completely still. If you move, the pictures may turn out blurry. This procedure takes about ten minutes, after which you need to get dressed and go about your business.
This diagnostic method is one of the cheapest and painless, non-invasive studies of the heart muscle. Only with x-rays with contrast, the patient can taste the lime solution of barium.
What is the threat to health from x-ray diagnostics
The effect of X-ray radiation on a person directly depends on the dose of radiation. After all, exposure to large doses of radioactive ionizing radiation can adversely affect the general condition and health, it lingers in tissues, destroys deoxyribonucleic acid and, accordingly, provokes disruption in the functioning of important organs and systems.
Since X-rays emit little radiation, people are afraid and avoid doing this type of examination. But X-ray machines emit a very small dose of radiation and do not cause cardinal harm to human health. At the same time, the World Health Organization recommends not taking x-rays more than once a year, reducing the risk of radiation accumulation.
Pros and cons of cardiac x-rays
The disadvantages of an x-ray of the heart is that with any movement of the patient or movement of the organs, in particular with contractions of the heart, the picture comes out of poor quality and blurry. In this case, the doctor will not be able to adequately assess the condition of the heart muscle. The study does not carry much information, it is necessary to process the film for a long time and there is a small probability of receiving radiation exposure with frequent x-rays.
On the positive side, this is the cheapest research method available for most patients. Today, there are a large number of x-ray rooms, both in polyclinics, outpatient clinics, and in every hospital. If you regularly undergo preventive examinations, then you can suspect changes in the contour and size of the myocardium at a very early stage. The advantage is that the patient can keep with him a lot of pictures from previous examinations, which allows the doctor to compare and evaluate the dynamics of diseases.
X-ray examination of the heart replaces a more modern method of examination, such as safe and accurate echocardiography. It is because of the low information content and insecurity of the method that doctors from all over the world use other, safer and better methods for diagnosing heart diseases. But for the annual preventive examination, it is chest X-ray that is the most optimal method to suspect diseases of the cardiovascular system.