Chest X-ray What is a chest X-ray and what can it show? An X-ray of the chest produces a black-and-white image of the lungs. It also shows an outline of the heart and the pulmonary arteries. A chest X-ray can show if your heart has become larger than normal. This often happens in people with pulmonary hypertension (PH) because the heart has to work harder. Chest X-rays can also be used to detect causes of breathlessness, other than PH, such as scarring of the lungs. Whether or not a person has PH, additional testing is normally needed to firmly establish a diagnosis. How is a chest X-ray done? A chest X-ray for PH is done like any other X-ray. You will be asked to stand still in front of an X-ray machine. In some cases, two X-rays of the chest will be taken. Watch a video of a chest X-ray, taken from the Pulmonary Hypertension Association (PHA UK) DVD, Understanding Pulmonary Hypertension – a guide to diagnosis and treatment, here.