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[Thoracic radiography as routine within cardiological diagnosis?]
Insights
Routine chest radiography offers no added value for screening patients with chronic heart failure or cardiac defects. Diagnosis can be achieved through modern noninvasive methods, making routine X-rays unnecessary except in specific cases.
Area of Science:
- Cardiology
- Radiology
- Diagnostic Imaging
Background:
- Chest radiography is commonly used for patients with suspected heart disease.
- Modern noninvasive diagnostic methods offer advanced capabilities.
Purpose of the Study:
- To prospectively assess the diagnostic and prognostic value of chest radiography in patients with heart disease.
- To compare the utility of chest radiography against modern noninvasive cardiac assessment techniques.
Main Methods:
- Prospective study of 201 consecutive patients (113 men, 88 women, age 60 [3-88] years) with suspected cardiac valvular defects or heart failure.
- Evaluated history, physical exam, ECG, ergometry, echocardiography, and chest radiography.
- Invasive investigations performed in 92 patients for comparison.
Main Results:
- The diagnostic value of chest radiography varied with the specific cardiac condition and its severity.
- Diagnosis was achievable without chest radiography in severe heart failure (NYHA class III/IV) and high-grade valvular defects (grade III/IV).
- Chest radiography provided no additional prognostic or therapeutic information in these patient groups.
Conclusions:
- Routine chest radiography is not valuable as a screening tool for chronic heart failure or cardiac defects.
- Noninvasive methods are sufficient for diagnosis in most cases.
- Chest radiography may be useful only in specific, well-defined clinical circumstances.
Objective:
As chest radiography is still frequently used routinely in patients suspected of heart disease, the study was undertaken prospectively to assess its value in view of the potentials of modern noninvasive methods.
Patients And Methods:
History, physical examination, electrocardiography, ergometry, echocardiography and colour Doppler echocardiography as well as chest radiography were undertaken in 201 consecutive patients (113 men, 88 women, age 60 [3-88] years) with known or suspected cardiac valvular defects or heart failure. Subsequently invasive investigations were performed in 92 of these patients.
Results:
The value of chest radiography depended on the nature and severity of the particular cardiac disease. The diagnosis was established without chest radiography in all defects (40 patients) of grade III or IV (New York Heart Association) or NYHA class III or IV heart failure (30 patients). Chest radiography provided no additional prognostic or therapeutic information.
Conclusion:
These data indicate that routine chest radiography is of no value as a screening method in patients with chronic heart failure or cardiac defects, except in a few clearly defined specific circumstances.