When do I need a chest x-ray?

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Conway Lien, MD
Neuroradiology
Watch as Imaging Medical Director Conway Lien, MD, of Regional Medical Center of San Jose, explains how chest X-rays can help detect problems in the lungs, heart and other parts of the chest cavity. 
Chest x-rays may be used to assess heart status (either directly or indirectly) by looking at the heart itself, as well as the lungs. Changes in the normal structure of the heart, lungs, and/or lung vessels may indicate disease or other conditions.

Conditions that may be assessed with a chest x-ray include, but are not limited to, the following:
  • heart enlargement (which can occur with congenital heart defects or cardiomyopathy)
  • pericardial effusion -- a buildup of excess fluid in between the heart and the membrane that surrounds it, often due to inflammation
  • pleural effusion -- a collection of blood or fluid around the lung
  • pneumonia, persistent cough, and other lung conditions
  • aneurysms -- ballooning of the walls of the great blood vessels, such as the aorta
  • bone fractures
  • calcification of heart structures (such as heart valves or aorta)
  • tumors or cancer
  • herniation of the diaphragm (the breathing muscle, the diaphragm, moves out of place)
  • pleuritis -- inflammation of the lining of the lung
  • pulmonary edema ("fluid in the lungs," which can occur with congenital heart disease or congestive heart failure)
Other reasons for performing a chest x-ray may include:
  • as part of the physical assessment before hospitalization and/or surgery or as part of a complete physical examination
  • to assess symptoms of conditions related to the heart or lungs
  • to assess progression of a condition and/or effectiveness of treatments
  • to check the position of implanted pacemaker wires and other internal devices such as central venous catheters, endotracheal tubes, chest tubes, or nasogastric tubes
  • to check status of lungs and chest cavity after surgery
There may be other reasons for your physician to recommend a chest x-ray.