The primary role of radiography in diagnosing congestive heart failure is for evaluation of the lungs. As we will learn in the next chapter there are a number of different radiographic findings that can occur in congestive heart failure. Radiography plays an important role in identifying and monitoring these changes.
In cases of congestive heart failure treatment with diuretic therapy can be monitored with thoracic radiographs. Congestive heart failure will most commonly respond to diuretic therapy and the pulmonary pattern will improve. As there is overlap between radiographic findings of heart failure and other pulmonary pathology such as pneumonia, fibrosis, acute lung injury and more, these non-cardiac causes will not respond to diuretic therapy.
Screening with thoracic radiographs to determine cardiac size also plays a role in monitoring and treating CHF. Patients with myxomatous mitral valve degeneration can be evaluated with radiographs to determine therapy to delay the onset of congestive heart failure. Those with left sided cardiomegaly and a murmur consistent with MMVD are candidates for pimobendan therapy.