Chest X-ray in Diagnosis of Heart Failure

Acute cardiac insufficiency (ICA) is a leading cause of acute dyspnea in the emergency department (SU) and is associated with a higher risk of morbidity and mortality.

An increasing number of tools for better ICA diagnosis are available in the SUs. However, there is likely room to improve the ICA diagnostic approach using widely available routine tools, including chest x-ray .

Chest x-ray is a rapid and inexpensive method that is routinely performed in an emergency in patients with acute dyspnea. This is the first-line diagnostic imaging modality recommended in the guidelines.

The objective of this study is to compare the performance of x-chest ray in the diagnosis of acute cardiac insuficiency through the interpretation of a senior and a non-senior.

A senior emergency physician or resident and an intern, perform a reading of chest x-ray in any included patient by answering to following questions:

Is there cardiomegaly? Calculation of the cardio-thoracic index Is there a vascular distribution towards the vertices, if so is it uni or bilateral? Is there pleurisy, if so is it uni or bilateral? Is there an interstitial syndrome, if so is it uni or bilateral? Is there an alveolar syndrome, if so if so is it single or bilateral? Is the diagnosis of heart failure very likely, likely or unlikely? Then there will be a comparison of the two answers.

Inclusion criteria

• Age over 18 All dyspnea acute non-traumatic A resident or intern in medicine and a senior are available to read chest x-ray within 24 hours of admission

Exclusion criteria

• Age under 18
• Post traumatic dyspnea
• Patient not requiring hospitalization
• Mechanical ventilation from the start
• Cardio-respiratory arrest
• Pregnant woman
• And any patient who cannot achieve reproducibility within 24 hours of admission.