The Bedside Chest Radiograph in the Evaluation of Incipient Heart Failure

Ninety-four patients had chest radiographs made on admission to a coronary care unit and daily thereafter for 1 days. Studies were carried out at bedside, in the postero-anterior projection, at 6 ft. (1.8 m) target-film distance, with the patient sitting. Thirty-one patients had radiographic evidence of congestive heart failure without clinical signs. In 23 of these, clinically evident failure subsequently developed. A “subclinical failure” group could thus be identified with a noninvasive technique. No useful information was obtained by filming patients clinically in failure, nor those in subclinical failure beyond day one. The most common sign of failure was distension of upper lobe vessels.