Chest X-rays Before Surgery

When you need one and when you don’t

Many people have a chest X-ray before they have surgery. This is called a “pre-op” chest X-ray. “Pre-op” stands for preoperative, which means that it is before an operation, or surgery.

If you have a heart or lung disease, you may want to get a pre-op chest X-ray. It can show medical problems, like an enlarged heart, congestive heart failure, or fluid around the lungs. These could mean that your surgery should be delayed or cancelled.

However, if you don’t have signs or symptoms of a heart or lung disease, you should think twice about having a chest X-ray before surgery. Here’s why:

A chest X-ray usually doesn’t help.

Many people are given a chest X-ray to “clear” them before surgery. Some hospitals require a chest X-ray for almost every patient.

But, if you do not have symptoms of a heart or lung disease, and your risk is low, an X-ray probably will not help. It is not likely to show a serious problem that would change your treatment plan.

And a chest X-ray does not help the surgeon or the anesthesiologist manage your care. Most of the time, a careful medical history and physical exam are all you need.

A chest X-ray can have risks.

A chest X-ray uses a very low radiation dose. Risks from radiation exposure may add up, so avoid X-rays you don’t need. Also, a chest X-ray can show something that looks to be abnormal. This is often a false alarm. But you will need follow-up tests to rule out a serious problem. This can cause anxiety, cost you money, and expose you to risks from the other tests.

A chest X-ray costs money.

Chest X-rays are not expensive. But any money spent on tests that you do not need is money wasted. And your health insurance may not pay for the X-ray if surgery is the only reason you’re having it.

When should you have a chest X-ray?

It is a good idea to have a chest X-ray before you have surgery or before you go into the hospital if:

  • You have signs or symptoms of a heart or lung condition. These include chest pain, coughing, shortness of breath, swelling in the ankles, fever, a recent heart attack, or a cold or other lung infection that does not go away.
  • You have a heart or lung disease, whether or not you have symptoms.
  • You are older than 70 and you have not had a chest X-ray within the last six months.
  • You are having surgery on the heart, lungs, or any other part of the chest.

This report is for you to use when talking with your health-care provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2016 Consumer Reports. Developed in cooperation with the American College of Radiology.