If you go to the ER complaining of chest pain or shortness of breath/difficulty breathing, the doctor will want to order a chest X-ray.

You may wonder if this type of image can show a heart attack or reveal clogged arteries.

Perhaps you were relieved when, in the emergency room, your chest X-ray came back “clear” or “normal,” and maybe this made you think you didn’t have coronary arteries full of sludge.

What does a cardiologist have to say?

I asked Monica Reynolds, MD, a cardiologist with ColumbiaDoctors Medical Group in White Plains, NY, if a chest X-ray can show if a patient had a heart attack.

Dr. Reynolds replies, “No. CXR could show congestive heart failure or an enlarged heart or a myriad of other problems, but it CANNOT show a heart attack.”

Chest pain and shortness of breath are common symptoms and can be caused by a number of other conditions that an X-ray can pick up, such as pneumonia and an aortic aneurysm.

Chest pain and shortness of breath can also be caused by conditions that an X-ray cannot detect, such as gastroesophageal reflux disease, costochondritis and extreme anxiety.

Why an X-ray Can’t Show a Heart Attack

An X-ray cannot see the inside of the coronary arteries. It can certainly see the shape and size of the heart.

But this imaging tool cannot produce a picture of an obstruction inside a heart’s blood vessel.

Nor can it show the difference between cardiac tissue that’s normal and that which has been harmed by lack of oxygen.

When a patient presents to the ER with symptoms that a heart attack can cause, doctors always know that there are other conditions that can produce the same symptoms.

These conditions will show up on an X-ray. The test that is key to diagnosing a heart attack is a blood draw for an enzymatic protein called troponin.

Since 1992 Dr. Reynolds has practiced clinical cardiology at ColumbiaDoctors Medical Group, one of the largest multi-specialty practices in New York State.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer. 


Top image: ©Lorra Garrick