CHEST X-RAY : what you should know and how to prepare for it

The chest x-ray is the most commonly performed diagnostic x-ray examination. A chest x-ray produces images of the heart, lungs, airways, blood vessels and the bones of the spine and chest. An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.

Uses and Procedure

The chest x-ray is performed to evaluate the lungs, heart and chest wall. A chest x-ray is typically the first imaging test used to help diagnose symptoms such as:

Physicians use the examination to help diagnose or monitor treatment for conditions such as:

Why is it Done?

A chest X-ray is often among the first procedures you’ll undergo if your doctor suspects you have heart or lung disease. It can also be used to check how you are responding to treatment.

A chest X-ray can reveal many things inside your body, including

The condition of your lungs : Chest X-rays can detect cancer, infection or air collecting in the space around a lung (pneumothorax). They can also show chronic lung conditions, such as emphysema or cystic fibrosis, as well as complications related to these conditions.

Heart-related lung problems : ChestX-rays can show changes or problems in your lungs that stem from heart problems. For instance, fluid in your lungs (pulmonary edema) can be a result of congestive heart failure.

The size and outline of your heart : Changes in the size and shape of your heart may indicate heart failure, fluid around the heart (pericardial effusion) or heart valve problems.

Blood vessels : Because the outlines of the large vessels near your heart — the aorta and pulmonary arteries and veins are visible on X-rays, they may reveal aortic aneurysms, other blood vessel problems or congenital heart disease.

Calcium deposits : Chest X-rays can detect the presence of calcium in your heart or blood vessels. Its presence may indicate damage to your heart valves, coronary arteries, heart muscle or the protective sac that surrounds the heart. Calcium deposits in your lungs are most often from an old, resolved infection.

Fractures : Rib or spine fractures or other problems with bone may be seen on a chest X-ray.

Postoperative changes : Chest X-rays are useful for monitoring your recovery after you’ve had surgery in your chest, such as on your heart, lungs or esophagus. Your doctor can look at any lines or tubes that were placed during surgery to check for air leaks and areas of fluid or air buildup.

A pacemaker, defibrillator or catheter : Pacemakers and defibrillators have wires (leads) attached to your heart to make sure your heart rate and rhythm are normal. Catheters are small tubes used to deliver medications or for dialysis. A chest X-ray usually is taken after placement of such medical devices to make sure everything is positioned correctly.

How Do I Get Ready For A Chest X-ray?

Your healthcare provider will explain the procedure to you. Ask any questions you have about the procedure. You may be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if anything is not clear.

You usually do not need to stop eating or drinking before the test. You also usually will not need medicine to help you relax (sedation). Tell your healthcare provider if you are pregnant or think you may be pregnant. Also wear clothing that you can easily take off or wear clothing that lets the radiologist reach your chest.

Finally, tell your healthcare provider if you have any body piercings on your chest and follow any other instructions your healthcare provider gives you to get ready.

What Happens During A Chest X-ray?

The chest X-ray is not painful. But you may have some discomfort or pain from moving into different positions if you have had recent surgery or an injury. The technologist will use all possible comfort measures and do the scan as quickly as possible to minimize any discomfort or pain.

Generally, a chest X-ray follows this process:

  1. You will be asked to remove any clothing, jewelry, or other objects that may get in the way of the test.
  2. They will give you a gown to wear.
  3. You may be asked to lie down, sit, or stand. Your position depends on what images the technologist needs.
  4. After which you will be asked to roll your shoulders forward, take in a deep breath, and hold it until the X-ray is made. If you are unable to hold your breath, the technologist will take the picture by watching how you breathe.
  5. You will need to stay still during the X-ray. Moving during the X-ray may affect the quality of the image.
  6. For a side-angle view of the chest, you will be asked to turn to your side and raise your arms above your head. You will be told to take in a deep breath and hold it as the X-ray is made.

What are the risks of a chest X-ray?

You may want to ask your healthcare provider about the amount of radiation used during the test. Also ask about the risks as they apply to you. Consider writing down all X-rays you get, including past scans and X-rays for other health reasons. Show this list to your healthcare provider. The risks of radiation exposure may be tied to the number of X-rays you have and the X-ray treatments you have over time.

Tell your healthcare provider if you are pregnant or think you may be pregnant. Radiation exposure during pregnancy may lead to birth defects. You may have other risks depending on your specific health condition. Talk with your healthcare provider about any concerns you have before the procedure.

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