Chest pain x ray: Difference between revisions

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==X Ray==
==X Ray==
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| Colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
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| Bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1''' In [[patients]] presented with acute [[chest pain]], [[chest radiograph]] is useful for evaluation of other potential causes of [[symptom]] including [[cardiac]], [[pulmonary]], [[thoracic]] origin .'' ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence C]])<nowiki>"</nowiki>''
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! colspan="2" style="background: PapayaWhip;" align="center" + |The above table adopted from 2021 AHA/ACC/ASE Guideline<ref name="pmid34709879">{{cite journal |vauthors=Gulati M, Levy PD, Mukherjee D, Amsterdam E, Bhatt DL, Birtcher KK, Blankstein R, Boyd J, Bullock-Palmer RP, Conejo T, Diercks DB, Gentile F, Greenwood JP, Hess EP, Hollenberg SM, Jaber WA, Jneid H, Joglar JA, Morrow DA, O'Connor RE, Ross MA, Shaw LJ |title=2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines |journal=Circulation |volume=144 |issue=22 |pages=e368–e454 |date=November 2021 |pmid=34709879 |doi=10.1161/CIR.0000000000001029 |url=}}</ref>
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An x-ray may be helpful in the diagnosis of common causes of chest pain. Findings on an x-ray  include:
An x-ray may be helpful in the diagnosis of common causes of chest pain. Findings on an x-ray  include:



Latest revision as of 07:31, 16 December 2021

Chest pain Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Chest pain from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Chest Pain in Pregnancy

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Interventions

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Chest pain x ray On the Web

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Risk calculators and risk factors for Chest pain x ray

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2]

Overview

An x-ray may be helpful in the diagnosis of common causes of chest pain.

X Ray

Class I
"1 In patients presented with acute chest pain, chest radiograph is useful for evaluation of other potential causes of symptom including cardiac, pulmonary, thoracic origin . (Level of Evidence C)"
The above table adopted from 2021 AHA/ACC/ASE Guideline[1]







An x-ray may be helpful in the diagnosis of common causes of chest pain. Findings on an x-ray include:

Aortic dissection[2][3][4]

Aortic dissection with marked widening of the mediastinum[5]
Aortic dissection with marked pleural effusion (blue arrow), left upper mediastinal mass (yellow arrow), and tracheal deviation (orange arrow)[6]

Pulmonary embolism[7][8][9][10]

    • Hampton hump: peripheral wedge-shaped density above the diaphragm
    • Westermark sign: vasoconstriction distal to the pulmonary embolus
    • Elevated hemidiaphragm
    • Pleural effusion
    • Palla's sign: enlarged right descending pulmonary artery

Pneumothorax[11]

Pneumothorax Source:Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 8250

Gastroesophageal reflux disease

Source: Case courtesy of Dr Hani Salam, From the case "https://radiopaedia.org/cases/9585">rID: 9585<

References

  1. Gulati M, Levy PD, Mukherjee D, Amsterdam E, Bhatt DL, Birtcher KK, Blankstein R, Boyd J, Bullock-Palmer RP, Conejo T, Diercks DB, Gentile F, Greenwood JP, Hess EP, Hollenberg SM, Jaber WA, Jneid H, Joglar JA, Morrow DA, O'Connor RE, Ross MA, Shaw LJ (November 2021). "2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 144 (22): e368–e454. doi:10.1161/CIR.0000000000001029. PMID 34709879 Check |pmid= value (help).
  2. de Lacey G, Morley S et-al. The Chest X-Ray: A Survival Guide. Saunders Ltd. ISBN:0702030465.
  3. Lai V, Tsang WK, Chan WC, Yeung TW (August 2012). "Diagnostic accuracy of mediastinal width measurement on posteroanterior and anteroposterior chest radiographs in the depiction of acute nontraumatic thoracic aortic dissection". Emerg Radiol. 19 (4): 309–15. doi:10.1007/s10140-012-1034-3. PMC 3396328. PMID 22415593.
  4. Gleeson CE, Spedding RL, Harding LA, et al The mediastinum—Is it wide? Emergency Medicine Journal 2001;18:183-185.
  5. Case courtesy of Dr Wayland Wang, Radiopaedia.org, rID: 50763
  6. Case courtesy of Dr Devanshi Pathania, Radiopaedia.org, rID: 68763
  7. Worsley DF, Alavi A, Aronchick JM, Chen JT, Greenspan RH, Ravin CE (October 1993). "Chest radiographic findings in patients with acute pulmonary embolism: observations from the PIOPED Study". Radiology. 189 (1): 133–6. doi:10.1148/radiology.189.1.8372182. PMID 8372182.
  8. Rossi SE, Goodman PC, Franquet T (June 2000). "Nonthrombotic pulmonary emboli". AJR Am J Roentgenol. 174 (6): 1499–508. doi:10.2214/ajr.174.6.1741499. PMID 10845470.
  9. CHANG CH, DAVIS WC (April 1965). "A ROENTGEN SIGN OF PULMONARY INFARCTION". Clin Radiol. 16: 141–7. doi:10.1016/s0009-9260(65)80007-1. PMID 14272525.
  10. Palla A, Donnamaria V, Petruzzelli S, Rossi G, Riccetti G, Giuntini C (September 1983). "Enlargement of the right descending pulmonary artery in pulmonary embolism". AJR Am J Roentgenol. 141 (3): 513–7. doi:10.2214/ajr.141.3.513. PMID 6603760.
  11. Sharma, Anita; Jindal, Parul (2008). "Principles of diagnosis and management of traumatic pneumothorax". Journal of Emergencies, Trauma and Shock. 1 (1): 34. doi:10.4103/0974-2700.41789. ISSN 0974-2700.

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