What is the role of chest radiography in the workup of hypoventilation syndromes?

Updated: Jul 22, 2021
  • Author: Jazeela Fayyaz, DO; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Perform a chest radiograph to rule out pulmonary disease as a cause of hypoventilation. Findings on chest radiographs that may help to determine the etiology of a hypoventilation syndrome include hyperinflation of lung volumes, diaphragm flattening, and elevation of the hemidiaphragms.

Hyperinflation of lung volumes and diaphragm flattening occur secondary to severe obstructive airway disease. With complicating pulmonary hypertension, the hilar vascular shadows are prominent secondary to pulmonary artery enlargement, and the cardiac silhouette may become prominent secondary to right ventricular enlargement.

Elevation of the hemidiaphragms may be related to diaphragm weakness or paralysis or to atelectasis.

Evidence of bony thoracic abnormalities, such as severe kyphoscoliosis, also may be present. Patients with mild kyphosis of scoliosis generally do not develop hypercapnia.

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