What cardiovascular disease processes may not be readily apparent on the chest x-ray?

Acute myocardial infarction without congestive heart failure

Coronary artery disease

Systemic hypertension (radiographic signs appear late)

Pulmonary hypertension (until advanced)

Intracardiac shunts with shunt ratio 1.5-2 to 1

Mild valvular disease

Pericardial effusion (unless large)

Aortic dissection

Remember that a normal (or âœnormal for ageâ) x-ray does not mean that the patient is normal!

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