Roentgen diagnosis of cardiac competence.

The classification of disease serves a useful purpose only if it furthers the understanding of the pathologic process or aids in diagnosis, prognosis, or treatment. Often the functional classification of heart disease is utilized by clinicians to the detriment of all these principles. We have been impressed on a number of occasions by the disparity between the functional state of the diseased heart and the physiological status as determined by catheterization. The roentgen appearance of the chest correlates well with the physiologic data and roentgenography is a simple method of following the patient's progress and response to therapy, though there have admittedly been cases where interpretation of the roentgen findings has been in error. When there is disagreement between the clinical and radiographic evaluation, there is a need for amplifying studies. The radiographic factors to be considered are cardiac size and configuration, pulmonary venous appearance, pulmonary arterial appearance, and the presence...