What Can a Chest X-Ray Tell Me?

Mar 3, 2023 1:49:00 PM Posted by Iowa Radiology


General xray with tech

A chest X-ray can provide valuable information about the condition of your heart, lungs, and surrounding structures. Doctors often order them to investigate respiratory or cardiac symptoms or to check for damage after a chest injury. Chest X-rays are also useful for monitoring progress after surgery to the chest and ensuring proper placement of medical devices like pacemakers and defibrillators. Below are some of the features radiologists examine in chest X-rays and the conditions they may shed light on. Depending on the results, a chest X-ray may be followed up with additional imaging such as MRI, ultrasound, or CT.


Heart Size and Shape

A chest X-ray allows the radiologist to visualize the size and shape of a patient’s heart. The heart can become enlarged due to damage or a condition that causes it to work harder than normal. Common conditions that can result in enlargement or alteration of the shape of the heart include

  • High blood pressure
  • Anemia
  • Damage from heart attack
  • Valve disorders
  • Cardiomyopathy (disease of the heart muscle)
  • Pericardial effusion (buildup of fluid around the heart)
  • Thyroid disorders
  • Pericarditis (inflammation of the pericardium)

Athletes who do rigorous cardiovascular training may experience a natural enlargement of the heart as they build this muscle. In this case, the heart is becoming more efficient. Even in athletes, however, it’s important for doctors to assess any enlargement of the heart to determine whether it’s simply the result of training or a sign of an underlying problem.


Blood Vessels

A chest X-ray provides a window into the aorta and the pulmonary arteries and veins. Examination of these blood vessels can allow doctors to detect aortic aneurisms, congenital heart disease, and calcium deposits that could indicate coronary artery disease.



Chest X-rays can reveal fractures and other damage to the ribcage, clavicle, spine, and shoulder blades. Because chest X-rays are quick and easy to perform, they’re particularly useful in emergencies involving traumatic injuries.



By examining the lungs on a chest X-ray, radiologists can detect and monitor cancers, pneumonia, and chronic lung diseases like emphysema, cystic fibrosis, and COPD. It can reveal fluid in the lungs (pulmonary edema), which often results from congestive heart failure. Doctors can also determine if air is building up outside the lung (pneumothorax), which can result from either injury or disease and lead to lung collapse.



Doctors most often use mammography, a specialized form of X-ray, to detect breast cancer. However, breast cancer can also show up on a standard chest X-ray. In patients diagnosed with breast cancer, a chest X-ray can give insight into how treatment is progressing and whether the cancer has spread to nearby structures such as the lungs.


What Won’t a Chest X-Ray Reveal?

While chest X-rays can provide a great deal of important information quickly, it has limitations. A pulmonary embolism, for example, which results from a blood clot lodging in the lung and preventing blood flow, will not show up on X-rays. A CT scan or other test is necessary to diagnose this condition.

Small cancers may also be missed in chest X-rays. A CT scan, which provides a more detailed, three-dimensional view of the area, can pick up smaller tumors and better pinpoint their locations. For patients who are at high risk of lung cancer, low-dose CT lung screening is an effective tool for catching developing cancers at the earliest stage possible.

Iowa Radiology has been providing cutting-edge imaging services in Central Iowa for more than twenty years. We use a wide range of imaging technologies, including MRI Scans, CT cardiac calcium scoring, low-dose CT lung screening, 3-D mammography, and more, often allowing us to provide any follow-up tests that may be needed. Results from chest and other X-ray exams in our clinics are sent to the referring physician within one business day.

For more information about medical imaging, browse our blog. We update it regularly with articles on important health care topics.

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American Cancer Society. Tests for Lung Cancer. Cancer.org. Published August 15, 2022. Accessed February 27, 2023. https://www.cancer.org/cancer/lung-cancer/detection-diagnosis-staging/how-diagnosed.html.

Cleveland Clinic. Athletes With Enlarged Hearts: Is It Harmless or Serious? ClevelandClinic.org. Published July 31, 2020. Accessed February 27, 2023. https://health.clevelandclinic.org/athletes-and-enlarged-hearts/.

Cleveland Clinic. Pulmonary Edema. ClevelandClinic.org. Published September 16, 2022. Accessed February 27, 2023. https://my.clevelandclinic.org/health/diseases/24218-pulmonary-edema.

Johns Hopkins Medicine. Pneumothorax. HopkinsMedicine.org. Published April 7, 2019. Accessed February 27, 2023. https://www.hopkinsmedicine.org/health/conditions-and-diseases/pneumothorax.

Mayo Clinic. Enlarged Heart. MayoClinic.org. Published May 4, 2022. Accessed February 27, 2023. https://www.mayoclinic.org/diseases-conditions/enlarged-heart/symptoms-causes/syc-20355436.

Mayo Clinic. Pulmonary Embolism. Published December 21, 2022. Accessed February 27, 2023. https://www.mayoclinic.org/diseases-conditions/pulmonary-embolism/diagnosis-treatment/drc-20354653.

WikiDoc. Pericarditis. WikiDoc.org. Updated July 29, 2020. Accessed February 27, 2023. https://www.wikidoc.org/index.php/Pericarditis_x_ray.

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