X-ray symptoms of heart failure

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

Changing the position of the heart. In a healthy person, the heart is in the anterior section of the thoracic cavity. When you change the position of the body, it moves within a few centimeters, making simultaneous rotations 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 shifted to the side with pleural effusion, a large diaphragmatic hernia, or a tumor. Pulling of the heart is often observed with the contraction of the lung tissue. The examination of the condition of the lungs and diaphragm usually makes it possible to easily 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. It depends on the position of the body in space and the level of the diaphragm standing. The shape of the heart is not the same in the child and adult, in women and men, but in general the heart in shape resembles an elongated oval, positioned obliquely in relation to the median line of the body. The border between the shadow of the heart and the shadow of the main vessels (the waist of the heart) is well defined, the contours of the cardiac silhouette are clearly distinguished, bounded by arched lines. Such a heart shape with clearly visible arches is considered normal.

Varied variations in the shape of the heart in pathological conditions can be grouped as follows: mitral, aortic and trapezoidal (triangular) forms. With the mitral form, the waist of the heart disappears, the second and third arcs of the left contour of the cardiovascular silhouette elongate and protrude more than usual into the left pulmonary field. Higher than normal, is the right cardiovascular angle. In aortic form, the waist of the heart, on the contrary, is sharply expressed, deep contouring of the contour appears between the first and fourth arcs of the left contour. The right cardiovascular angle is mixed downwards. The arches are more elongated and more convex, corresponding to the aorta and the left ventricle of the heart.

By itself, the mitral or aortic configuration of the heart does not yet prove the presence of the disease. The shape of the heart, close to the mitral, is found in young women, and close to aortic - in elderly people of the hypersthenic constitution. An indication of a pathological condition is the combination of the mitral or aortic form of the heart with its increase. The most common cause of the formation of the mitral form of the heart is an overload of the left atrium and right ventricle. Consequently, mitralization of the heart is primarily carried out by mitral heart defects and obstructive pulmonary diseases, in which the pressure in the small circulation increases. Overflow of the left ventricle and the ascending part of the aorta is the most frequent cause of the aortic configuration of the heart. It leads to aortic malformations, hypertension, atherosclerosis of the aorta.

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. At the same time, the division of its outlines into separate arcs is lost. A similar shape of the heart is usually called trapezoid or triangular. It occurs in diffuse lesions of the myocardium (dystrophy, myocarditis, myocardiopathy) or in the presence of effusion in the hearth shirt (exudative pericarditis).

Change in the size of the heart. Changing the size of the heart chambers is an important sign of the pathological condition. The expansion of the chambers is detected using ray methods. This is most readily available with ultrasound and radiographic studies. A general increase in the heart can occur as a result of effusion in the pericardium, or as a result of the expansion of all chambers of the heart (congestive cardiopathy). Ultrasound can immediately distinguish between these two states.

Much more often it is necessary to diagnose the enlargement of individual chambers of the heart. Again, echography (M-method or sonography) is of primary importance here. X-ray signs of an increase in individual chambers of the heart are the elongation and large convexity of the corresponding arc on the roentgenogram.

Change in heart contractions. With the help of radiation methods, the frequency of cardiac contractions and vascular pulsations, the depth and rhythm of contractions, the velocity of the movement of the heart wall at the time of contraction, the direction of movement (normal or paradoxical), the appearance of additional contractions and relaxations, the change in the thickness of the walls of the heart at the time of contraction and relaxation . All these symptoms of heart damage are usually established in sonography, less often, if it is not possible to perform it, using fluoroscopy. Normally, the range of motion of the wall of the left ventricle is 10-12 mm, and the right - 4-5 mm.