​Children's Heart Center

Chest X-Ray

X-rays are generated by using low levels of external radiation to produce images of the body, organs and other internal structures for diagnostic purposes. X-rays pass through body structures onto plates similar to camera film and a “negative” type picture is made. The more solid a structure is, the whiter it appears on the film. For this reason, bones appear very white on an X-ray film, but less dense tissue – such as muscle, blood, skin, and fat – appears darker.

Chest X-rays may be used to assess heart status by looking at the heart and lungs. Changes in the normal structure of the heart, lungs and/or lung vessels may indicate disease or other conditions.

Chest X-rays are often useful in assessing patients with these conditions:

  • Heart enlargement (which can occur with congenital heart defects or cardiomyopathy)
  • Pericardial effusion – a build-up of excess fluid between the heart and the membrane that surrounds it, often due to inflammation
  • Pleural effusion – a collection of blood or fluid around the lung
  • Pulmonary edema – fluid in the lungs, which can occur with congenital heart disease or congestive heart failure
  • Pneumonia and other lung diseases

X-rays also can be used to compare heart and lung status, assess symptoms related to conditions of the heart or lungs, and check the position of implanted pacemaker wires and other internal devices such as central venous catheters.

Performing a Chest X-Ray

  • In most cases there will be a special table in a room with a large X-ray camera suspended from the ceiling. Portable X-ray equipment can be used to make films on patients in areas of the hospital, such as the operating room, the emergency department or the intensive-care unit.
  • A chest X-ray may be performed in a standing, sitting or lying position, depending on the condition of the patient and the reason for the X-ray. For a standing or sitting film, the patient will stand or sit in front of an X-ray plate. If the X-ray is taken in the lying position, the plate is placed beneath the patient while lying on his or her back or side.
  • The technician will position the patient in front of the plate and then will step away to the controls of the machine. If the patient is old enough to cooperate, he or she will be asked to take a deep breath and hold it for a few seconds while the X-ray exposure is made. Otherwise, the technician will try to take the picture at the appropriate time by watching the patient breathe.
  • In some situations, the physician may want a film made from a side view. This procedure is the same as the one just described, except the patient will stand, sit or lie at a right or left angle to the X-ray plate with their arms raised out of the way.
  • Parents are often requested to stay in the room with the patient to provide support and encouragement. During the exam, parents will be asked to wear a lead apron to protect them from unneeded exposure to radiation during the X-ray.