Cardiac disease in pregnancy chest x ray

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]

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.

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.

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]

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