What does a chest x-ray rule out?
August 7, 2016 10:21 AM   Subscribe

YANMD. In fact, I went to my doctor on Friday because I'd been experiencing some shortness of breath with exertion, but no pain. The shortness of breath resolves within five minutes of stopping activity. I'm 57 and obese. Over the past year, I've lost 30 pounds and gotten my blood pressure from high to normal through diet and exercise (this morning: 116/68). I've also been experiencing tremendous emotional stress for about six months. I've had a chronic cough ever since I had a severe upper respiratory infection in January.

My doctor ordered a chest x-ray, a stress test, and some lung function testing. She has told me to stop fencing until after the stress test (super bummer). It will be a few weeks for the other tests, but I have the chest x-ray results now. I'd like to know what they can rule out.

These are the results in their entirety:
1. No acute cardiopulmonary disease.
2. Stable mildly enlarged cardiac silhouette.
Comparison 11/11/2008

I don't have access to the 2008 results.
I am, of course, worried and freaking out a bit about all of this. I'm guessing I can quit freaking out about lung cancer. Obviously, the enlarged cardiac silhouette is not a good thing. But is there anything I can stop worrying about now? Any other general thoughts are welcome too. Thanks.
posted by FencingGal to Health & Fitness (7 answers total) 1 user marked this as a favorite
It's ok to call the doctor and ask what she was ruling out with the xray. She ordered the test for a reason, and likely there are things ruled out by it that actually apply to your case.

When I had some breathing issues a couple decades ago, I was much younger than you and generally healthy except the lung problem- so for me, they were ruling out valley fever, and then another time ruling in (boo) walking pneumonia. But your doc has your particular history and can tell you what specifically she was looking for. This sort of question should be answerable without an appointment- either via phone or an online health portal.
posted by nat at 10:40 AM on August 7, 2016

Sorry, I mean answerable by *your* medical team, using the phone to call them or their online portal if they have one. It's really ok to ask for a clear explanation of test results, particularly if your worry may make you feel worse.
posted by nat at 10:42 AM on August 7, 2016

posted by My Dad at 11:00 AM on August 7, 2016 [2 favorites]

Best answer: I have adult-onset asthma. Every time it flares up my doctor orders x-rays to rule out pneumonia. My guess is that your doctor wants to make sure that the respiratory infection you experienced and your chronic cough aren't the result of pneumonia. I think you should put a strikethrough on the "lung cancer" entry on your mental worry list, because asthma or its precursor, reactive airway disease, are much more likely possibilities.
posted by mudpuppie at 11:25 AM on August 7, 2016 [4 favorites]

I had a lung x-ray a while back to rule out sarcoidosis. If it were that, my understanding is that it's usually very treatable.
posted by ArbitraryAndCapricious at 11:25 AM on August 7, 2016

Lung scarification?
posted by Michele in California at 11:50 AM on August 7, 2016

Best answer: IANYD.

The CXR is a standard screening test for cardiopulmonary issues. Many - but not all - things that cause shortness of breath will be picked up by it. Pneumonia, lung cancer, fluid around the lungs (called a pleural effusion), fluid in the lungs (due to congestive heart failure).

A chest x-ray can miss some things though, and some things that cause shortness of breath (Asthma, anxiety, cardiac ischemia) will have a normal CXR.

What you've had is, essentially, a normal result and quite reassuring.

My advice would be to feel reassured and then to let your doc get all the information she's appropriately reached out to get, and use her to help you interpret the language and figure out the next steps.
posted by cacofonie at 11:52 AM on August 7, 2016 [9 favorites]

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