Radiology and Images of Important Diseases

Dr. Nasr Eldin Yousif Ahmed
Associate Professor of Medicine & Cardiology
Department of Medicine
Al Maarefa University

How to Read Chest X Ray

Remember ABCDE

A. Airway
B. Bone
C. Cardiomegaly
- Cavitation
- Calcification
D. Density
E. Effusion

Normal X-Ray

wire

-Cardiomegaly

what drugs should be given

Aspirin but - warfarin

follow up monthly for PT/INR

St of drug + bleeding

The figure shows a 12-lead ECG tracing on a standard red grid. The leads are labeled as follows:

The tracing shows a series of waves for each lead, with a clear progression of the QRS complex and T waves. A small scale bar is visible in the bottom right corner of the grid.

I aVR V1 V4

II aVL V2 V5

III aVF V3 V6

Regular

160 b/min

2/17/2026

Dr. Nasr Eldin Yousif Ahmed

Supraventricular tachycardia (pocket in reentry)

Ux: →

1st line → Vagal stimulation

2nd line → Adenosine or verapamil

Four ECG leads (I, II, III, aVF) showing a normal sinus rhythm with a clear P wave, QRS complex, and T wave. The leads are stacked vertically.

irregular

Atrial fibrillation

Ux: →

Rate control → BB blocker

Rhythm control → Antiarrhythmic drugs

Antiarrhythmation

The figure shows a 12-lead ECG tracing on a standard red grid. The leads are labeled as follows:

Ventricular tachycardia

if Cardiac arrest → CPR & DC shock

if conscious → Amiodarone

→ wide QRS
monomorphic
Regular

VENTRICULAR FIBRILLATION

Ventricular fibrillation
III → CPR & DC shock

VENTRICULAR STANDSTILL (Asystole)

Asystole
to check the pt.

Pulseless electrical activity = EMD

Normal ECG

PEA ECG

To the body

To the lungs

SA node

Left atrium

Right atrium

Left ventricle

AV node

Right ventricle

in elderly
complete dissociation between atrium & ventricle
Profound bradycardia
III → Pace maker

Pace maker
in pt. with complete heart block
on ECG
with QRS
Pacemaker spikes (spikes before QRS)
in dual pace maker
with QRS
Pacemaker spikes (spikes before QRS / p-wave)

haemorrhous opacity in Rt. upper lobe
Pneumonia
Antibiotic

Pt. 2 days ago had typical ischemic chest pain. Now he’s having SOB

Pulmonary edema
due to Rupture cardiac tamponade or
low wall ventricle or Septum
or Extensive MI
imp. investigation to do?
echo

consultation
most imp diagnosis..
TB
pt. having fever, ill 3 days
Lung Abscess

Cardiomegaly DDx
* Cardiac tamponade “Globose heart”
Congestive heart failure
multivascular lesion
ischemic cardiomyopathy
dilated cardiomyopathy
most imp investigation?
Echo

Left Side pneumothorax
Shift of trachea

Pt. is known case of Asthma / COPD / Emphysema

Shift of trachea
Left Side pneumothorax
Utr. →
Health Decompression = Pt. intercostal space
than chest tube

The diagram illustrates the intercostal chest drainage procedure. On the left, a patient’s torso shows the drainage tube inserted into the chest. On the right, a cross-section of a normal lung is shown with labels for the pleura, pleural space, and lung. Below the lung, a diagram shows the drainage container with a water seal and a collection bottle. Labels include: Patient, Normal Lung, Bilets or Bulbous, Collapsed Lung, Air in Pleural Space, Intercostal Chest Drainage, Tube, Air Vent, Drainage Container, Collection, and Water Seal.

Patient

Normal Lung

Bilets or Bulbous

Collapsed Lung

Air in Pleural Space

Intercostal Chest Drainage

Tube

Air Vent

Drainage Container

Collection

Water Seal

Pleural effusion
homogeneous opacity
hll. → Aspiration

Miliary TB

TB, a fibrous body

cavitation
fibrosis

TB: • fibrocavitory lesion

Another important finding that you should not

malignancy
lung metastasis

L
ERECT

malignancy
”lung metastasis”

Patient stoi

Pace maker

Physical exam

hilar lymphadenopathy
lymphoma
TB

Xanthelasma

imp. test → lipid profile

imp drug → Atorvastatin

SE → myopathy , hepatitis

Arcus senilis

Physical exam

diagnosis: 1 kg hyperlipidemia

Xanthoma

A 12-lead ECG tracing on a standard grid background. The leads are labeled: I, aVR, aVL, aVF, II, III, and V1 through V6. Lead V2 is highlighted with a yellow circle. Lead aVR is also highlighted with a yellow circle.

I aVR aVL aVF
II III V1 V2 V3 V4 V5 V6

Atheros MI
left anterior descending artery

A 12-lead ECG tracing on a standard grid. The leads are labeled: I, aVR, V1, V4, II, aVL, V3, V5, III, aVF, V2, V6. Leads II and aVF are highlighted with yellow circles.

I aVR V1 V4
II aVL V3 V5
III aVF V2 V6

inferior MI
PL coronary artery
Suspected PL ventricular infarction

The figure is a 12-lead ECG tracing on a standard pink grid. The leads are labeled: I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, and V6. The tracing shows a regular sinus rhythm with clear P, Q, R, S, and T waves. The paper speed is 25mm/s and the voltage is 1mV. The patient’s name is ‘Shawland’.

Shawland

12-lead ECG tracing with leads I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, and V6.

25mm/s 10mm/mV 400Hz 060C 1206.204 CD: 1

Universal ST segment elevation with concave upwards PR segment depression

Pericarditis
Uk. → WASD

A 12-lead ECG tracing on a standard pink grid. The leads are labeled: I, aVR, II, aVL, III, aVF, V1, V2, V3, V4, V5, and V6. The tracing shows a regular sinus rhythm with clear P, Q, R, S, and T waves. There are no obvious pathological changes such as ST-segment depression or Q-waves.

I aVR II aVL III aVF V1 V2 V3 V4 V5 V6

Electrical Alterations

Rhythmical affection
Cardiac temperature

Pulmonary Edema

Ull. →

Put

Sitting position
for anxiety → morphine, automatic
transducer

the only indication for inotropes “dopamine"
"dobutamine”

is hypotensive (cardiogenic shock or
HF with L BP)

Coronary artery c shape
”narrowing”
used for IHD
Coronary Angiography
Ull. →
Stent

midsternal thoracotomy scar (CABG or
vascular replacement)

2 mmunics bedside should be done

look at legs for Scar of Saphenous vein
if no scar → either LIMA or RIMA

I hear the click sound of valve

Pulmonary edema

Blunted costophrenic angles

Normal

Effusions

Two side-by-side chest X-rays. The left image is labeled ‘Normal’ and shows clear costophrenic angles. The right image is labeled ‘Effusions’ and shows blunted costophrenic angles with fluid accumulation in the pleural space.

The title at the top reads ‘Blunted costophrenic angles’.

pleural effusion