مجله دانشگاه علوم پزشکی بیرجند (Feb 2013)
Chest X ray diagnostic accuracy in heart failure of dyspnic patients referring to the emergency ward
Abstract
Background and Aim: Heart failure (H.F) is a burgeoning prevalent problem worldwide, which has involved over 20 million people. Echocardiography is the best standard process in diagnosing H.F. Thus, it is one of the first measures which should be taken for patients referring to the emergency ward. In the present study, the rate of chest X-ray diagnostic accuracy with respect to the occurrence of heart failure of dyspnic patients referring to the emergency ward was verified. Materials and Methods: The present study was done on 125 dyspnic patients referring to the emergency ward of Valli-e-asr hospital. Their CXR and echocardiography were done. Then, the chest radiographs were reported by a radiologist who evaluated them regarding signs of heart failure such as, prebrachial cuffing, CTR, right and left pleural effusion, septal line, hilus change, right descending pulmonary artery width, carina angle, vascular pedicle width, lung opacities, azygos vein width, distribution of blood flow, and sensitivity of these signs .Finally, by adding 3 markers with the highest diagnostic sensitivity together a new diagnostic marker was inferred from them. Results: It was found that, the Carina angle had the highest sensivity and azygos vein the least(86.5% and 13%,respectively).A new diagnostic marker emerged by adding 3 existant markers(carina angle. hilus change.CTR) with the highest sensitivity and specificity of 78.5 and 52.5%,respectively. Conclusion: According to the present studying CXR findings can be helpful in the diagnosis of HF as the underlying cause of dyspnea in patients referring to the emergency ward.