14.10 : Imaging Studies for Cardiovascular System III: X-Ray

The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.

Definition and Purpose

An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular diseases.

Indications for Cardiac X-ray Imaging

Cardiac X-ray imaging is indicated in clinical scenarios, such as evaluating symptoms like chest pain, shortness of breath, and persistent cough. It is essential for diagnosing conditions like heart failure, congenital heart defects, cardiomyopathy, and pericardial disease, as well as for preoperative and postoperative assessments and routine follow-ups in patients with known cardiovascular conditions.

Procedure

Cardiac X-ray imaging is a fast process. Patients are placed on a table or against a surface, sometimes with help from a technologist, for the best image quality. A lead apron protects against unnecessary radiation. The X-ray machine emits radiation that passes through the body to a detector or film, completing in just a few minutes. Patients can continue normal activities right after.

Nursing Care

Nursing care for cardiac X-ray imaging encompasses pre-procedural, procedural, and post-procedural stages to ensure patient safety and accurate results.

1. Pre-Procedure: Nurses check patient identity, confirm the exam, review medical histories for allergies (e.g., to contrast media), check pregnancy status, and have patients remove jewelry and wear a hospital gown.
2. During the Procedure, Nurses assist in positioning patients for radiology, using lead aprons to protect them from radiation, and ensuring patient comfort while forwarding any instructions from the radiologic technologist.
3. Post-Procedure: Nurses monitor patients for adverse reactions, offer post-procedure advice, and instruct when to report unusual symptoms.

Findings in Cardiac X-ray Imaging

Cardiac X-ray imaging can reveal various findings. An enlarged heart shadow may indicate cardiomegaly, often associated with heart failure or cardiomyopathy. Changes in the size and shape of the heart chambers can suggest valvular heart disease or congenital abnormalities. Calcifications within the coronary arteries may be visible, indicating atherosclerosis. Excessive fluid in the lungs, known as pulmonary edema, is often associated with congestive heart failure. These findings guide further diagnostic testing and treatment plans.

Limitations and Risks

While X-ray imaging is a valuable tool in cardiac diagnostics, it does have limitations and associated risks. Although minimal, exposure to ionizing radiation is a consideration, especially for pregnant women and children.