If you go to the ER with chest pain, the doctor will always want to give you an X ray, but just what can this show?

One of the first things you’ll get if you go to the ER with chest pain is an X-ray. An X-ray cannot detect clogged arteries or if you had a heart attack, so why is this such a common procedure in the emergency room?

“Many times, chest X-rays are done unnecessarily, especially if the patient just had a normal one recently,” says Dr. Sameer Sayeed, a cardiologist at ColumbiaDoctors of Somers, NY.

“The only reasons a chest X-ray may be repeated in the above instance is if the MD was suspicious of congestive heart failure from chest pain that may be due to a new heart attack,” continues Dr. Sayeed.

Congestive heart failure is when the heart is not pumping adequate amounts of blood. This situation can cause chest pain, which alerts the ER doctor that the patient could have congestive heart failure, especially if elderly.

The congestive heart failure may have been there for a while, or, it could be the result of a heart attack that the patient just had. Congestive heart failure causes fluid buildup that is seen on the X-ray.

Other conditions that the X-ray can detect are “cardiac ischemia, a pericardial effusion that could cause chest pain, pneumonia that could cause chest pain or the rare instance that a previously normal aorta now had a problem,” adds Dr. Sayeed.

Cardiac ischemia means insufficient oxygen to the heart. Pericardial effusion means fluid buildup within the sac that surrounds the heart. Pneumonia is a bacterial or viral infection in the lungs.

An abnormally enlarged section of the aorta, called an aneurysm, can cause chest pain, though usually, an aortic aneurysm causes no symptoms and these are discovered by accident when the patient is getting imaged for something unrelated.

Even if you go to the ER very frequently with complaints of chest pain, and all the previous workups were normal including the X-ray, you’ll still likely get an X-ray.

This is because, if you actually do turn out to have a serious problem that was missed, and decide to sue the doctor, the doctor’s defense will be able to show that standard of care was met because a baseline battery of tests was ordered—which would include the chest X-ray.

Dr. Sayeed performs echocardiograms and stress tests at the Midtown Manhattan and Westchester offices at Columbia Doctors. He is also trained in cardiac CT imaging.
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.