Presentation
Cardiology clinic attender with previous cardiothoracic surgery. Chest pain.
Patient Data
Pacemaker.
Moderate cardiomegaly.
The lungs are clear.
The MVR is barely discernable on the frontal film, but well illustrated on the lateral projection.
The value of inverting the image in identifying the valve
The MVR partially overlying the spine is better identified with the image contrast inverted.
Case Discussion
Iatrogenic objects, especially those overlying bone and on under-penetrated films, can be hard to identify or assess accurately.
Re-imaging may not be necessary. Inverting the image contrast ( a button click on PACS ) may be all that is needed.
This process is particularly useful on CXR's to identify heart valves and the positions of lines and tubes, such as an NG tube tip.