X-ray symptoms of a heart lesion

A cardiologist, thanks to radiation methods, receives extensive information about the morphology and function of the heart and main vessels, objective data on the slightest deviations from the norm. Based on the numerous symptoms identified, the final clinical diagnosis of the disease is made. It is advisable to consider the signs of heart pathology that are most often observed by a general practitioner. These are mainly radiological symptoms of changes in the position, shape, size and contractile function of the heart.

Changes in the position of the heart. In a healthy person, the heart is located in the anterior lower part of the chest cavity. When the body position changes, it moves within a few centimeters, simultaneously rotating around the vertical and horizontal axes. One of the congenital anomalies is the right-sided position of the heart - its dextroposition. The heart can be displaced to the side with exudative pleurisy, a large diaphragmatic hernia or a tumor. Constriction of the heart is often observed with wrinkling of the lung tissue. An examination of the lungs and diaphragm usually makes it easy to establish the cause of the abnormal position of the heart.

Changes in the shape of the heart. The shape of the heart in the X-ray image is a variable value. It depends on the position of the body in space and the level of the diaphragm. The shape of the heart is not the same in a child and an adult, in women and men, but in general the shape of the heart resembles an elongated oval, located obliquely in relation to the midline of the body. The border between the shadow of the heart and the shadow of the main vessels (the waist of the heart) is quite well defined, the contours of the heart silhouette are clearly distinguished, limited by arched lines. Such a shape of the heart with clearly visible arcs is considered normal.

Various variations of the heart shape in pathological conditions can be grouped as follows: mitral, aortic and trapezoid (triangular) shapes. In the mitral shape, the waist of the heart disappears, the second and third arches of the left contour of the cardiovascular silhouette are lengthened and protrude more than usual into the left pulmonary field. The right cardiovascular angle is located higher than normal. In the aortic shape, the waist of the heart, on the contrary, is sharply expressed, between the first and fourth arches of the left contour there is a deep depression of the contour. The right cardiovascular angle shifts downwards. The arches corresponding to the aorta and the left ventricle of the heart are lengthened and more convex.

The mitral or aortic configuration of the heart itself does not prove the presence of the disease. The heart shape close to mitral is found in young women, and close to aortic - in older people with a hypersthenic constitution. A sign of a pathological condition is a combination of mitral or aortic heart shape with its enlargement. The most common cause of the mitral heart shape is overload of the left atrium and right ventricle. Consequently, mitral heart defects and obstructive pulmonary diseases, which increase pressure in the pulmonary circulation, lead primarily to mitralization of the heart. The most common cause of aortic heart configuration is overload of the left ventricle and ascending aorta. Aortic defects, hypertension, and atherosclerosis of the aorta lead to it.

Diffuse lesions of the heart muscle or accumulation of fluid in the pericardium cause a general and relatively uniform increase in the shadow of the heart. In this case, the division of its outlines into individual arcs is lost. This form of the heart is usually called trapezoidal or triangular. It occurs with diffuse lesions of the myocardium (dystrophy, myocarditis, myocardiopathy) or with effusion in the pericardium (exudative pericarditis).

Change in heart size. Change in the size of the heart chambers is an important sign of a pathological condition. Enlargement of the chambers is detected using radiation methods. This is most easily detected with ultrasound and X-ray examinations. General enlargement of the heart can occur as a result of effusion in the pericardium or as a result of enlargement of all heart chambers (congestive cardiopathy). Ultrasound examination allows one to immediately differentiate between these two conditions.

Much more often, it is necessary to diagnose the enlargement of individual chambers of the heart. Again, here the main significance is given to echography (M-method or sonography). Radiological signs of enlargement of individual chambers of the heart are elongation and greater convexity of the corresponding arc on the radiograph.

Changes in heart contractions. Radiation methods can be used to assess the heart rate and vascular pulsation, the depth and rhythm of contractions, the speed of the heart wall during contraction, the direction of movement (normal or paradoxical), the appearance of additional contractions and relaxations, changes in the thickness of the heart walls during contraction and relaxation. All these symptoms of heart damage are usually determined by sonography, less often, if it is not possible to perform it, by fluoroscopy. Normally, the range of movement of the left ventricle wall is 10-12 mm, and the right - 4-5 mm.