Cardiac disease in pregnancy chest x ray: Difference between revisions

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Latest revision as of 20:48, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Lakshmi Gopalakrishnan, M.B.B.S. [3]

Overview

Performance of routine chest x-rays should be avoided, especially in the first trimester of pregnancy. A chest x ray may be indicated in the pregnant patient with dyspnea ^[1] or cough ^[1]. Among patients with dyspnea, a chest x-ray may be obtained to eavluate the patient for the presence of heart failure due to peripartum cardiomyopathy. In this scenario, the chest x ray may show cardiomegaly, Kerley B lines, pleural effusion and cephalization of blood vessels.

Chest X Ray

Normal Chest X-Ray Findings During Pregnancy

A normal chest x-ray during normal pregnancy may reveal physiologic changes such as increased left ventricular dimension and cardiomegaly, which in the absence of dyspnea is usually secondary to the elevation of diaphragm and should be interpreted with caution.

Precautions

The preferable estimated fetal exposure from ionizing radiation should be kept below 50 mGy and with chest x-ray, the exposed radiation is <0.01 mGy.^[1]^[2] Although the theoretical risk of irradiation to the fetus is low, the pelvic area should be shielded if chest x-ray is performed and the radiation dose should be documented in the medical record.^[3]

References

↑ ^1.0 ^1.1 ^1.2 "ACOG Committee Opinion. Number 299, September 2004 (replaces No. 158, September 1995). Guidelines for diagnostic imaging during pregnancy". Obstetrics and Gynecology. 104 (3): 647–51. 2004. PMID 15339791. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
↑ Damilakis J, Theocharopoulos N, Perisinakis K, Manios E, Dimitriou P, Vardas P, Gourtsoyiannis N (2001). "Conceptus radiation dose and risk from cardiac catheter ablation procedures". Circulation. 104 (8): 893–7. PMID 11514375. Retrieved 2012-04-17. Unknown parameter |month= ignored (help)
↑ Osei EK, Faulkner K (1999). "Fetal doses from radiological examinations". The British Journal of Radiology. 72 (860): 773–80. PMID 10624343. Retrieved 2012-04-18. Unknown parameter |month= ignored (help)

Template:WikiDoc Sources CME Category::Cardiology

[pmid15339791-1] 1.0 ^1.1 ^1.2 "ACOG Committee Opinion. Number 299, September 2004 (replaces No. 158, September 1995). Guidelines for diagnostic imaging during pregnancy". Obstetrics and Gynecology. 104 (3): 647–51. 2004. PMID 15339791. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)

[pmid11514375-2] Damilakis J, Theocharopoulos N, Perisinakis K, Manios E, Dimitriou P, Vardas P, Gourtsoyiannis N (2001). "Conceptus radiation dose and risk from cardiac catheter ablation procedures". Circulation. 104 (8): 893–7. PMID 11514375. Retrieved 2012-04-17. Unknown parameter |month= ignored (help)

[pmid10624343-3] Osei EK, Faulkner K (1999). "Fetal doses from radiological examinations". The British Journal of Radiology. 72 (860): 773–80. PMID 10624343. Retrieved 2012-04-18. Unknown parameter |month= ignored (help)

[1]

[2]

[3]

@@ Line 1: / Line 1: @@
+__NOTOC__
 {{Cardiac disease in pregnancy}}
 {{CMG}}; {{AOEIC}} {{CZ}}; {{LG}}
-==Indications==
+==Overview==
-*[[Dyspnea]]<ref name="pmid15339791">{{cite journal |author= |title=ACOG Committee Opinion. Number 299, September 2004 (replaces No. 158, September 1995). Guidelines for diagnostic imaging during pregnancy |journal=[[Obstetrics and Gynecology]] |volume=104 |issue=3 |pages=647–51 |year=2004 |month=September |pmid=15339791 |doi= |url= |accessdate=2012-04-17}}</ref>
+Performance of routine chest x-rays should be avoided, especially in the first trimester of pregnancy.  A chest x ray may be indicated in the pregnant patient with [[dyspnea]] <ref name="pmid15339791">{{cite journal |author= |title=ACOG Committee Opinion. Number 299, September 2004 (replaces No. 158, September 1995). Guidelines for diagnostic imaging during pregnancy |journal=[[Obstetrics and Gynecology]] |volume=104 |issue=3 |pages=647–51 |year=2004 |month=September |pmid=15339791 |doi= |url= |accessdate=2012-04-17}}</ref> or [[cough]] <ref name="pmid15339791">{{cite journal |author= |title=ACOG Committee Opinion. Number 299, September 2004 (replaces No. 158, September 1995). Guidelines for diagnostic imaging during pregnancy |journal=[[Obstetrics and Gynecology]] |volume=104 |issue=3 |pages=647–51 |year=2004 |month=September |pmid=15339791 |doi= |url= |accessdate=2012-04-17}}</ref>.  Among patients with [[dyspnea]], a chest x-ray may be obtained to eavluate the patient for the presence of [[heart failure]] due to [[peripartum cardiomyopathy]].  In this scenario, the chest x ray may show [[cardiomegaly]], [[Kerley B lines]], [[pleural effusion]] and [[Congestive heart failure chest x ray#Cephalization|cephalization of blood vessels]].
-*[[Cough]]<ref name="pmid15339791">{{cite journal |author= |title=ACOG Committee Opinion. Number 299, September 2004 (replaces No. 158, September 1995). Guidelines for diagnostic imaging during pregnancy |journal=[[Obstetrics and Gynecology]] |volume=104 |issue=3 |pages=647–51 |year=2004 |month=September |pmid=15339791 |doi= |url= |accessdate=2012-04-17}}</ref>
+==Chest X Ray==
+===Normal Chest X-Ray Findings During Pregnancy===
+A normal chest x-ray during normal pregnancy may reveal physiologic changes such as increased left ventricular dimension and [[cardiomegaly]], which in the absence of [[dyspnea]] is usually secondary to the elevation of diaphragm and should be interpreted with caution.
-==Precautions==
+===Precautions===
 The preferable estimated fetal exposure from ionizing radiation should be kept '''below 50 mGy''' and with chest x-ray, the exposed radiation is '''<0.01 mGy'''.<ref name="pmid15339791">{{cite journal |author= |title=ACOG Committee Opinion. Number 299, September 2004 (replaces No. 158, September 1995). Guidelines for diagnostic imaging during pregnancy |journal=[[Obstetrics and Gynecology]] |volume=104 |issue=3 |pages=647–51 |year=2004 |month=September |pmid=15339791 |doi= |url= |accessdate=2012-04-17}}</ref><ref name="pmid11514375">{{cite journal |author=Damilakis J, Theocharopoulos N, Perisinakis K, Manios E, Dimitriou P, Vardas P, Gourtsoyiannis N |title=Conceptus radiation dose and risk from cardiac catheter ablation procedures |journal=[[Circulation]] |volume=104 |issue=8 |pages=893–7 |year=2001 |month=August |pmid=11514375 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=11514375 |accessdate=2012-04-17}}</ref> Although the theoretical risk of irradiation to the fetus is low, the pelvic area should be shielded if chest x-ray is performed and the radiation dose should be documented in the medical record.<ref name="pmid10624343">{{cite journal |author=Osei EK, Faulkner K |title=Fetal doses from radiological examinations |journal=[[The British Journal of Radiology]] |volume=72 |issue=860 |pages=773–80 |year=1999 |month=August |pmid=10624343 |doi= |url=http://bjr.birjournals.org/cgi/pmidlookup?view=reprint&pmid=10624343 |accessdate=2012-04-18}}</ref>
-==Chest X-Ray Findings==
-Routine chest x-ray is avoided, especially in the first trimester.
-Chest x-ray in normal pregnancy may reveal physiologic changes such as increased left ventricular dimension and [[cardiomegaly]], which in the absence of [[dyspnea]] is secondary to the elevation of diaphragm and should be interpreted with caution.
-Among patients with [[dyspnea]], chest x-ray in done to identify the presence of [[heart failure]], which may show [[cardiomegaly]], [[Kerley B lines]], [[pleural effusion]] and [[Congestive heart failure chest x ray#Cephalization|cephalization of blood vessels]].
 ==References==
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