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cardiomegaly is stable. patient status post median sternotomy. there are no focal consolidations concerning for pneumonia. no pleural effusion or pneumothorax. bibasilar atelectasis is stable.
dyspnea and productive cough.
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a dual lead pacemaker is in-situ. there is a cardiac vascular stent positioned at the level of the aortic valve. no pneumothorax seen. there is mild linear right-sided atelectasis, new when compared to the prior study. no consolidation or pneumothorax seen. no evidence of pulmonary edema. there is unchanged mild cardiomegaly.
<unk> year old woman s/p dual chamber ppm. // assess lead placement and r/o ptx.
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pa and lateral views of the chest provided. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
<unk>m with epigastric pain/sob after prolonged cocaine use.
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lungs are clear. there is no pneumothorax. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
<unk>m with chest pain // ptx?
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the heart is normal in size. the aorta is calcified and tortuous. there is no pleural effusion or pneumothorax. a nodular opacity projecting over the left lower lung suggests a nipple shadow rather than a true pulmonary nodule. vague opacity is noted in the basilar right lower lobe in both views. bony structures are unremarkable.
weakness and syncope.
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ap view of the chest provided. there is interval placement of a right-sided pleural catheter. there is no pneumothorax. right sided pleural effusion has minimally improved since prior study. left lung base is clear. massive cardiomegaly again seen. patient is status post mitral and tricuspid valve replacements.
<unk> year old man with large right effusion s/p pigtail placement, evaluate for pneumothorax.
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lateral view is nondiagnostic due to the patient's inability to raise his arms. the lung volumes are low. cardiac, mediastinal and hilar contours are normal. lungs are clear. no pleural effusion or pneumothorax is present. no acute osseous abnormalities are visualized.
severe lumbar spine stenosis.
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the cardiac silhouette is stably enlarged. again noted is mild central pulmonary vascular congestion. the previously seen right internal jugular sheath is no longer noted. there is no pneumothorax or definite pleural effusion. no consolidation is identified. increased conspicuity of opacity is seen at the right lung base, which may represent atelectasis, though consolidation is not excluded. an aicd is in appropriate, unchanged position.
<unk> year old man with chf exacerbation // cvl positioning, e/o pulm edema or other acute process
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indistinct pulmonary vascular markings are noted throughout the lungs. there is no confluent consolidation. probable small pleural effusions are noted with blunting of the posterior costophrenic angles. cardiac silhouette is enlarged in part accentuated by ap technique. atherosclerotic calcifications seen at the aortic arch. no acute osseous abnormality.
<unk>f with reported chest pain this am, + n // eval for cardiopulmonary pathology
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peribronchial opacity at the base the left lung could be atelectasis or aspiration. if it is pneumonia it is extremely early. there is no pleural effusion, pulmonary edema or pneumothorax. the heart size is normal. the mediastinal contours are normal.
history: <unk>m with fever // r/o acute process
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single frontal view of the chest was obtained. overlying trauma board limits detailed evaluation. the heart size and cardiomediastinal contours are normal. the lungs are clear. no focal consolidation, pleural effusion, or pneumothorax. no displaced rib fracture.
<unk>-year-old female with fall.
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right lower lobe cavitary lesion is present. right basilar opacity likely representing pleural effusion is noted. there is no pneumothorax. the left lung is clear. a hand overlies the lower chest. the cardiomediastinal silhouette is within normal limits.
<unk> year old woman with rll abscess s/p rll tbbx // ptx
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ap upright and lateral views of the chest provided. evaluation slightly limited due to underpenetration without convincing signs of pneumonia or overt chf. no large effusion or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
<unk>f with elevated wbc // r/o pna
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et tube in situ with the tip just above the medial clavicles approximately <num> mm proximal to the carina. right-sided picc line in situ with the tip in the mid to distal svc. no pneumothorax. ng tube in situ coursing out of sight inferiorly. bilateral pulmonary venous congestion. left lower lobe atelectasis with a small associated effusion. mild right basal atelectasis with a suspected small effusion.
this is a <unk> yom with a pmh significant for developmental mental delay, seizure disorder, and blindness who is being admitted to the ccu following pericardial drainage for a moderate to large pericardial effusion. currently the patient is hemodynamically stable with drain in place pending extubation and f/u investigation regarding the etiology of his pericardial effusion. // et tube placement
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the lungs are well-expanded and clear. no pleural effusion or pneumothorax. heart size, mediastinal contour, and hila are unremarkable. the aorta is mildly tortuous.
<unk> year old woman with right blurry vision, right sided numbness. any masses? acute cardiopulmonary process?
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the tracheostomy tube position cannot be confirmed on this exam. again seen is extensive subcutaneous emphysema in the lateral chest wall, pectoralis muscles and cervical regions bilaterally, overall slightly improved compared to the prior exam. there is mild pneumomediastinum, overall improved compared to the prior exam. underlying coarse interstitial pulmonary markings are again noted. there appears to be bilateral unchanged diffuse reticulonodular interstitial process with a more focal airspace confluent opacity at the right apex. the lungs remain hyperinflated. the cardiac and mediastinal contours are otherwise stable. chain sutures at the left apex are again noted. again noted is pneumomediastinum. the right basilar pneumothorax appears to have improved compared to the prior exam. there are probable small bilateral pleural effusions.
history of tracheal laceration. please assess for position of the trach.
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there are bilateral diffuse airspace opacities, with more confluent consolidations in the lung bases. a nodular component cannot be excluded. assessment of the pleural sulci is limited as both were left out of the imaging frame. the cardiomediastinal and hilar contours are unremarkable. there is no pneumothorax. endotracheal tube is seen ending <num> cm above the carina. there is no cardiomegaly.
<unk>-year-old male recently intubated. evaluate for position of endotracheal tube.
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the cardiomediastinal and hilar contours are stable. there is no pleural effusion or pneumothorax. the lungs are hyperexpanded and clear without focal consolidation concerning for pneumonia. a <num> lead pacemaking device is present with leads terminating in the right atrium, right ventricle, and coronary sinus as expected.
<unk> year old man s/<unk> crt-d s/p left axillary vein access // confirm lead placement
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heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.
history: <unk>f with chest pain on exertion // evaluate for acute coronary syndrome
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the lungs are clear. heart size mediastinal contours are normal. there is no pleural effusion or pneumothorax. osseous structures are intact.
history: <unk>m s/p fall from standing today, l shoulder upper thoracic pain // eval for shoulder fracture, eval for rib fracture
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compared with <unk>, moderate to severe cardiomegaly, moderate pulmonary vascular congestion, and mild associated interstitial pulmonary edema have increased. there is no pleural effusion. there is no focal consolidation or pneumothorax. the cardiomediastinal silhouette is within normal limits.
<unk>m with sob evaluate for volume overload.
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patient is status post median sternotomy and cabg. the cardiac and mediastinal silhouettes are stable. . mild bibasilar atelectasis without focal consolidation. no pleural effusion or pneumothorax. the lateral view is limited due the patient's overlying arm. again seen chronic deformity at the distal right clavicle.
history: <unk>m with s/p fall // eval for pneumothorax
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lungs are clear without focal consolidation, effusion, or edema. the cardiomediastinal silhouette is within normal limits. hypertrophic changes are seen in the spine.
<unk>m with worsening sob, sweating // herart failure v pneumonia
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the cardiac silhouette size is normal. the aorta is mildly tortuous and demonstrates minimal aortic knob calcification, unchanged. the mediastinal and hilar contours are stable. lungs are clear without focal consolidation. no pleural effusion or pneumothorax is present. the pulmonary vascularity is not engorged. the lungs are hyperinflated with flattening of the diaphragms. there are multilevel degenerative changes in the thoracic spine.
palpitations for <num> hour.
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multiple metallic densities projecting over the left posterior lower chest are grossly unchanged compared to <unk>. cardiomediastinal silhouette is normal. there is no pleural effusion or pneumothorax. visualized osseous structures are normal.
<unk>-year-old man with posterior chest pain and fever and cough, recent low energy mvc.
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heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.
history: <unk>f with cough x <num> weeks
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the newly placed dobbhoff tube ends in the upper stomach. there has been interval removal of an enteric catheter. a left pacemaker is redemonstrated, with right atrial and right ventricular leads, unchanged. the lungs remain clear. the heart size is normal. the mediastinal contours are normal. there are no pleural effusions. no pneumothorax is seen.
eating disorder, now with new dobbhoff tube.
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there is chronic tracheal deviation of trachea and thyroid mass that remains grossly unchanged. tracheal stent is not well visualized on this study. there are bilateral pleural effusions remains unchanged from earlier same-day exam. there is no pneumothorax.
<unk> year old woman with mediastinal mass // please image more of neck to assess for position of airway stent
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the heart is mildly enlarged. the aorta is tortuous. the aortic arch is heavily calcified. there is a convex contour to the right upper mediastinum, fairly typical for mediastinal contour frequently seen with tortuosity of the great vessels, but are not specific. other etiologies including lymphadenopathy or a large thyroid nodule could be considered. a band-like opacity in the lingula suggests minor atelectasis or scarring. there is also streaky posterior left basilar opacity which suggests minor atelectasis or scarring. there is more generally a mild interstitial abnormality suggesting slight vascular congestion, including peribronchial cuffing, although possibly airway inflammation could yield a similar appearance. there is no pleural effusion or pneumothorax. the bones appear demineralized. mild degenerative changes are noted along the mid thoracic spine, which also demonstrates mild rightward convex curvature centered along the lower thoracic spine.
right upper quadrant pain.
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allowing for low lung volumes and portable technique, heart is upper limits of normal in size. thoracic aorta is tortuous. no focal areas of consolidation are identified within the lungs. left pleural effusion is small.
<unk> year old woman with hypoxia // atelectasis vs. pna
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the cardiac, mediastinal and hilar contours appear stable. there is no pleural effusion or pneumothorax. slight subpleural thickening at each lung apex is stable and typical for minor scarring of doubtful clinical significance in most cases.
positive ppd.
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pa and lateral views of the chest. the left-sided pacemaker is seen and unchanged in position. there is severe cardiomegaly, as seen on prior study. there is no focal consolidation, pleural effusion, or pneumothorax. the mediastinal and hilar contours are normal and unchanged.
dyspnea on exertion, history of hypertrophic cardiomyopathy, pacemaker placed one week ago.
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pa and lateral chest x-rays were obtained. our records do not include a previous exam for comparison. note is made of sternotomy wires and surgical <unk> related to prior cabg. the heart size is mildly enlarged, and there is moderate widening of the thoracic aorta. there is prominent pleural scarring on the right side and blunting of the right costophrenic sulcus presumably related to prior empyema; however, there is no evidence of free fluid. the lungs are otherwise clear. there is no pneumothorax.
<unk>-year-old with end-stage renal disease status post pneumonia and empyema.
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cardiomediastinal silhouette is remarkable for left ventricular configuration of the heart and a mildly tortuous thoracic aorta. there is no focal consolidation or pleural effusion. no pneumothorax. severe degenerative changes are again noted in the left glenohumeral joint as well as a large loose body.
history: <unk>f with chest pain, lower extremity edema. // infectious? cardiomyopathy?
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pa and lateral views of the chest provided. the heart is mildly enlarged. hilar congestion is noted with interstitial pulmonary edema and small bilateral pleural effusions. no pneumothorax is seen. bony structures are intact.
<unk>f with dyspnea on exertion
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the lungs are well-expanded and clear. no focal consolidation to suggest a focal pneumonia. no effusion or pneumothorax. the heart is normal in size. the mediastinum is not widened. the trachea appears normal in caliber. no acute osseous abnormality. nonspecific gaseous distension but not abnormal dilatation of the partially visualized loop of large bowel in the left upper quadrant is noted.
<unk> year old woman with increased seizure frequency. evaluate pulmonary process.
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a portable view of the chest shows a right ij ending in the upper svc. bilateral lung opacities, most pronounced in the right lower lobe, and cardiomegaly is consistent with pulmonary edema. pleural effusions are small, if any. there is no pneumothorax.
<unk> year old man with rij, assess position.
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frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. the lungs are clear. there is no pneumothorax, pleural effusion, or vascular congestion.
<unk>-year-old female with anoxia and low blood sugar. question infection.
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compared to <unk>, there has been interval removal of the chest tube. there is decreased in left upper lobe and left basal opacity. residual left pleural effusion is small. the lateral pleural abnormality is not seen on today's exam. the right lung is grossly clear. the heart size is mildly enlarged and unchanged from prior. the mediastinal contours are unchanged from prior. surgical clips are seen in the left upper lobe. left subdiaphragmatic drain is seen. no pneumothorax is seen.
<unk> year old man with pleural effusion. evaluate for pleural effusions.
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no focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema is seen. the heart size is top normal. mediastinal contours are normal. no bony abnormality is detected.
obesity, sleep apnea, chest pain and shortness of breath.
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the lungs are clear without consolidation, effusion, or edema. cardiac silhouette is enlarged but stable. left chest wall triple lead pacing device again noted. median sternotomy wires are intact. there is leftward deviation of the trachea at the thoracic inlet raising the possibility of underlying right-sided thyroid enlargement. no acute osseous abnormalities.
<unk>m with chest pain // chest pain
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the lungs are hyperexpanded similar to the prior study with emphysematous changes. heart size is normal. the mediastinal and hilar contours are normal. there is no pleural effusion or pneumothorax. there is anterior fusion of several upper thoracic levels.
history: <unk>f with weakness, malaise // eval for pneumonia
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there has been interval placement of a right central venous line which terminates in appropriate position, and there is no pneumothorax following placement.. the endotracheal tube and nasogastric tube are in stable position. there continues to be low lung volumes and bilateral severe diffuse pulmonary opacities.
<unk>-year-old female with ards, right internal jugular central venous line placement
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single portable view of the chest is compared to previous preop films from <unk>. right ij central line is seen with catheter tip in the mid svc. lungs are clear of focal consolidation or effusion. cardiomediastinal silhouette is within normal limits. osseous and soft tissue structures are unchanged, noting absorption of the distal right clavicle, widening of the ac joint. no free air is seen below the diaphragm.
<unk>-year-old female status post kidney transplant, postop.
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there are low lung volumes, which accentuate the bronchovascular markings. given this, subtle lateral left base opacity is seen which may be due to atelectasis, underlying consolidation is difficult to exclude. no focal consolidation is seen on the right. no large pleural effusion is seen. there is no pneumothorax. the cardiac and mediastinal silhouettes are unremarkable. there may be minimal pulmonary vascular congestion, likely accentuated by low lung volumes. an ovoid radiopaque structure is seen overlying the epigastric region, to the left of midline, not seen on the lateral view, and may be external to the patient.
history: <unk>f with weakness // r/o acute process
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there has been interval removal of a left-sided pigtail catheter. there is no pneumothorax. the moderate left pleural effusion is increased compared to the prior film, and there is adjacent atelectasis. the remainder of the chest radiograph is stable.
<unk>-year-old status post left pigtail catheter removal.
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heart size remains severely enlarged. mediastinal contour is unchanged. there is mild pulmonary vascular engorgement. elevation of the right hemidiaphragm persists, and again raises concern for a subpulmonic effusion. bibasilar opacities likely reflect atelectasis. no pneumothorax is seen. there are no acute osseous abnormalities.
history: <unk>m with dyspnea on exertion and lower extremity edema
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in comparison to the most recent examination, the left basilar atelectasis has resolved. the cardiomediastinal silhouette and pulmonary vasculature are unchanged and unremarkable. there is no pleural effusion or pneumothorax.
history: <unk>m with dilated cardiomyopathy, cad s/p stent, presenting with ongoing left-sided chest pain. evaluate for ptx, pe, pna, pulmonary edema etc. // <unk> presenting w/ chest pain. evaluate for ptx, evidence of pe, pna, pulmonary edema, or other pulmonary causes of chest pain.
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heart size is mildly enlarged. the mediastinal and hilar contours are unchanged with the aorta appearing somewhat unfolded. pulmonary vasculature is normal. lungs are clear. no focal consolidation, pleural effusion or pneumothorax is present. there are no acute osseous abnormalities.
history: <unk>m with chest pain and shortness of breath
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frontal and lateral views of the chest are compared to previous exam from <unk>. the lungs are clear of consolidation or effusion. cardiomediastinal silhouette is within normal limits. tortuous aorta is noted. osseous and soft tissue structures are unremarkable. there is increased lucency at the right lung base, likely below the hemidiaphragm suspicious for intraperitoneal air.
<unk>-year-old female with fever, one week status post bowel obstruction and recent bowel surgery.
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heart size is normal. mediastinal and hilar contours are within normal limits. lungs are clear. pulmonary vascularity is normal. no pleural effusion or pneumothorax is present. no acute osseous abnormalities are present.
syncope.
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the lungs are well inflated and clear. the cardiomediastinal silhouette and hilar contours are stable. there is no pleural effusion or pneumothorax.
<unk>-year-old woman with cough. evaluate for pneumonia.
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pa and lateral chest views were obtained with patient in upright position. available for comparison is the next preceding chest examination of <unk>. on the present examination, the heart size is within normal limits, and no configurational abnormalities are identified. the pulmonary vasculature is not congested. on the right lung base and located in the posterior segment of the right lower lobe, there is a discrete parenchymal density indicative of a pneumonic infiltrate. there is no pleural reaction and the right lateral as well as posterior pleural sinus is free from any fluid accumulation. the left lung base is unremarkable. on the frontal view, one can identify, in the right apical area, some scattered small parenchymal infiltrates overlying partially the proximal clavicular area and reaching the apical pleural space. the left apical area appears free, and no pneumothorax is present. comparison with the next preceding chest examination of <unk> enables one to clearly identify the right lower lobe pneumonia as being new. similarly, the right apical area was clean on the preceding examination. one can also see that there are some linear densities from the right hilum into the direction of the right apical area. the appearance of the lesion, although not typical, raised the possibility of specific tuberculous infection. noteworthy is that on the preceding examination in <unk>, the heart size was considerably larger than it is now, although it might still have been within normal limits.
<unk>-year-old male patient with hiv, cd<num> at <num> of <unk>% six month ago. anxiety disorder, now newly on hiv treatment three times a week with atripla. several days fever as high as <num>, night sweats, dyspnea. right pectoral region discomfort, cough productive of yellow sputum. is there right-sided pneumonia? hilar lymphadenopathy? evidence <unk> <unk> or tb?
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lower lung volumes with bilateral mid and lower zone haziness likely related to pleural effusions and underlying atelectasis. no lobar consolidation noted. there is persistent cardiomegaly. no significant interval change in bony thorax. the patient has now been extubated with removal of enteric tube.
ms. <unk> is an <unk> woman with systolic hf (global ef previously <unk>%, now <unk>%) and dm ii who presented with altered mental status in the setting of two days of diarrhea with subsequent shock (cardiogenic vs. septic), found to have worsened cardiac function requiring dobutamine gtt and possible pe on heparin gtt, now called out from ficu after successful extubation and downtitration of pressors. she has probable cardiac amyloid, ef <unk>% with increasing leukocytosis // evidence of pneumonia
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frontal and lateral views of the chest are compared to previous exam from <unk>. the lungs are clear without consolidation, effusion or pulmonary vascular congestion. cardiomediastinal silhouette is normal. dual-lead pacing device again seen with lead tips in the right atrium and right ventricle. osseous and soft tissue structures are unremarkable.
<unk>-year-old female with weakness.
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cardiomegaly is similar in degree when compared to prior. aortic core valve device is in stable position. median sternotomy wires the mediastinal clips are again noted. prominence of the interstitial markings are seen without overt edema. there is no effusion. osseous structures are unremarkable.
<unk>m with chf with worsening cp and productive cough // volume overload? pna?
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linear left lower lung atelectasis/scarring is re- demonstrated. no new focal consolidation is seen. there is no pleural effusion or pneumothorax. the cardiac and mediastinal silhouettes are stable.
history: <unk>m with ?aphasia around <num>am. h/o cerebellar mas // ?pna
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ap portable upright view of the chest. the heart is moderately enlarged though unchanged. the aorta appears calcified and unfolded. retrocardiac space is suboptimally assessed. allowing for low lung volumes, the right lung is clear. peg tube projects over the upper abdomen on the left. no pneumothorax. no right effusion. no large left effusion. bony structures are intact with degenerative changes again noted at the right shoulder.
<unk>f with anemia, tachycardia // ? infectious process
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patient is status post median sternotomy and cabg. heart size remains moderately enlarged. the aorta is tortuous. mediastinal and hilar contours are otherwise unchanged and unremarkable. no pulmonary edema is present. minimal atelectasis is noted in the lung bases without focal consolidation. no pleural effusion or pneumothorax is present. hypertrophic changes are noted in the thoracic spine.
history: <unk>m with cough and chest tightness
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since <unk>, slightly increased opacity and size of the mass in the a right perihilar region. the right lower lung mass appears unchanged since <unk>. no new focal consolidation to suggest pneumonia. no pleural effusion, pneumothorax, or pulmonary edema. stable cardiomediastinal silhouette and hila. the left port-a-cath appears intact and unchanged in position. stable elevation of the left hemidiaphragm.
<unk> year old woman with hx metastatic breast canecr w/known pulmonary mets with temp up to <num> not neutropenic; evaluate for pneumonia.
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the lungs are mildly hyperinflated with mild flattening of the hemidiaphragms. left midlung linear atelectasis is present. the lungs are otherwise clear. the heart and mediastinum are within normal limits. there is no pneumothorax.
<unk> year old man with copd, bilateral wheezing, cough. evaluate for pneumonia.
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the lungs are well expanded. homogeneously distributed diffuse interstitial markings are seen, suggestive of an old interstitial abnormality. there is no evidence of pneumonia or pulmonary edema. there is no pleural effusion or pneumothorax. the cardiomediastinal silhouette demonstrates mild cardiomegaly.
confusion.
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the heart is normal in size. the mediastinal and hilar contours appear within normal limits. there is no pleural effusion or pneumothorax. a biliary stent projects over the right upper quadrant.
fever and recent diagnosis of hepatic mass.
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decreased fluid and increased air in the right basilar hydropneumothorax, where the pleural catheter resides. similar size of adjacent right pleural effusion. right lower lobe atelectasis is unchanged. left pleural effusion remains small. heart size is stable.
<unk> year old man with new fevers. evaluate for pneumonia.
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extensive reticular interstitial opacities, predominantly in the lung apices, are unchanged and are consistent with fibrotic changes from sarcoidosis. minor fissure remains elevated. no pleural effusion, pneumothorax or focal airspace consolidation.there is persistent elevation of the left hemidiaphragm. hilar and mediastinal lymphadenopathy is unchanged. heart is top normal in size. there is no evidence for pulmonary edema.
history of asthma and sarcoid now with shortness of breath and cough. evaluate for pneumonia.
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heart size is mildly enlarged, increased compared to the prior exam, but partially accentuated due to slightly low lung volumes. the aortic knob is calcified. the mediastinal contours are otherwise unchanged. there is no pulmonary edema. no focal consolidation, pleural effusion or pneumothorax is noted. lung volumes are slightly low with crowding of the bronchovascular structures. no acute osseous abnormality is visualized.
chest pain, rapid atrial fibrillation.
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there is a retrocardiac opacity seen on the frontal view which is not confirmed on the lateral view. there are bilateral atelectatic changes. there is no pleural effusion or pneumothorax. the cardiac and mediastinal silhouettes are unremarkable.
<unk> year old man with low grade temp, wheezes // is there pneumonia
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compared to radiograph <num> minutes prior, no significant interval change seen. again seen is elevation of the left hemidiaphragm with associated left basilar opacity which is a combination of moderate sized left pleural effusion, basilar atelectasis, and possible underlying infection. the right lung is clear. no change in severely dilated pulmonary arteries or enlarged cardiomediastinal silhouette. no pneumothorax. vertical rod with screws in the right humerus again seen.
dyspnea, hypoxia. assess for pneumonia.
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the left hemidiaphragm is mildly elevated. no discrete focal consolidation is seen. there is no large pleural effusion. no pneumothorax is seen. the cardiac and mediastinal silhouettes are stable. previously seen a pulmonary edema has improved in the interval with possible mild central pulmonary vascular engorgement. degenerative changes are noted along the spine.
history: <unk>m with h/o systolic chf ef <unk>%, htn, ckd stage iv presenting with sob and fatigue // evidence of new effusions/fluid or other cause for sob?
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single frontal view of the chest demonstrates tracheostomy in standard position and intact median sternotomy wires. multiple surgical clips in the right upper lung base compatible with history of right upper lobectomy for squamous cell carcinoma. configuration of near complete opacification of the right lung with a large pleural effusion and elements of loculation in the right upper lobe and in subpulmonic location appears similar as compared to one day prior, with a small area of somewhat better aerated lung in the mid right hemithorax. the left lung is better aerated, with persistent left basilar atelectasis and small effusion. there is no discernable pneumothorax. cardiomediastinal silhouette is within normal limits allowing for semi-upright positioning and ap technique. there is evidence of posterior thoracotomy with disruption of posterior ribs.
<unk>-year-old female with pneumonia. question interval change.
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a new left lingular opacity is concerning for pneumonia in the correct clinical setting. the right lung is clear. no effusions. the cardiomediastinal and hilar contours are normal.
<unk> year old man with cough for over a month. looking for etiology. evaluate for consolidation.
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compared with earlier the same day and allowing for technical differences, no gross change is identified. diffuse bilateral opacities are similar in appearance and distribution. subtle differences in the right mid and lower zones could be accounted for by differences in film technique. mediastinum remains midline. no gross effusion is identified. no pneumothorax is detected. no free air seen beneath the diaphragm.
<unk> year old man with multifocal pna, ?lung ca, acutely worsened resp status concerning for pulm edema // assess for pulm edema
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the right lung volume is stable with chronic eventration of the hemidiaphragm. interval decrease and left lung volume with development of a small left pleural effusion. no pulmonary edema. no pneumothorax. the heart is top-normal in size. the mediastinal and hilar contours are normal without dilation of the svc or pulmonary veins. .median sternotomy clips are intact. the left pacemaker is intact with leads terminating in the appropriate positions of right atrium and right ventricle.
<unk> year old man with hx of atrial fibrillation, on amidarone therapy. rales left base and mild edema // annual evaluation on amiodarone therapyr/o chf
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there is a right-sided picc line in situ, which probably terminates in the upper part of the superior vena cava shortly below the confluence of the brachiocephalic veins, somewhat pulled back from its prior position. however, because of overlying soft tissue attenuation, the catheter is difficult to follow into the mediastinum, so it may terminate somewhat lower in the superior vena cava. the cardiac, mediastinal, and hilar contours appear unchanged. there is no pleural effusion or pneumothorax. the lungs appear clear.
status post picc line placement. history of lymphoma.
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small left apical pneumothorax is slightly increased compared to <num> day prior. there has been reaccumulation of small left pleural effusion. left chest tube is noted projecting over the left basal pleural space. cardiac silhouette is normal size.
<unk> year old woman with ?pleural effusion // ?pleural effusion
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heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.
history: <unk>m with chest pain
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ap upright and lateral views of the chest were performed. lung volumes are low. allowing for this, the lungs appear clear without focal consolidation, effusion, or pneumothorax. the overall cardiomediastinal silhouette appears stable. bony structures appear intact. there is no free air below the right hemidiaphragm.
<unk>-year-old female with change in mental status, question pneumonia.
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pa and lateral views of the chest. left chest wall pacer again seen with tips in the right atrium and right ventricle. the lungs remain clear without consolidation or pulmonary vascular congestion. cardiac silhouette is slightly enlarged but unchanged in configuration. no acute osseous abnormality is detected.
<unk>-year-old male with prior myocardial infarction now with dizziness.
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the cardiac, mediastinal and hilar contours appear unchanged. the lungs appear clear. there are no pleural effusions or pneumothorax.
neutropenic fever.
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left-sided port-a-cath is unchanged in position. the heart size is normal. note is made of a subtle increase in opacity in the right infrahilar region as well as mild peribronchial cuffing. there is no evidence of a pleural effusion or pneumothorax. deformity of the left proximal humerus is chronic.
history of fall, tenderness. please evaluate for traumatic injuries.
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there is no consolidation, pleural effusion, or pneumothorax. cardiomediastinal and hilar silhouettes are normal size.
history: <unk>m with fever and cough // infiltrate
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pa and lateral views of the chest provided. the heart is top-normal in size. the mediastinal contour is normal. no focal consolidation, large effusion or pneumothorax. no convincing signs of congestion or edema. bony structures are intact. no free air below the right hemidiaphragm.
<unk>m with chest pain
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the et tube is approximately <num> cm above the carina. the enteric tube terminates in the stomach, unchanged. the left subclavian central venous catheter terminates in left brachiocephalic vein, unchanged. the lung volume is small. no consolidation. no pleural effusions or pneumothorax. the heart size and azygous vein are slightly enlarged
<unk> year old man with right frontal mass intubated // ett placement eval
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the cardiac, mediastinal and hilar contours are stable including post-operative changes along the superior hilum. elevation of the left hemidiaphragm is stable and reflects a probably unchanged subpulmonic pleural effusion. the lungs appear clear.
head strike and left-sided chest wall tenderness.
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in comparison to the prior study there is mild improvement in severe diffuse pulmonary edema. moderate cardiomegaly is unchanged. focal consolidation would be difficult to exclude given the degree of pulmonary edema. there is no large pleural effusion or pneumothorax.
history: <unk>f with ams and cough // eval for pna, effusions
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frontal and lateral views of the chest. the lungs are clear of focal consolidation or effusion. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities detected.
<unk>-year-old male with jerking movements. question infection.
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a right-sided port-a-cath is in stable position. the cardiomediastinal and hilar contours are stable. postoperative changes of the right hemi thorax are stable. there is no focal consolidation, pleural effusion or pneumothorax. no evidence of pulmonary edema.
<unk> year old man with lymphoma // increased shortnes of breath and wheezing. assess for abnormalities.
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the right internal jugular central venous catheter ends in the low svc, as before. there is evidence of prior midline sternotomy and cabg. lung volumes remain low. there is subsegmental bilateral lower lung atelectasis, not significantly changed. moderate enlargement of the cardiac silhouette is slightly increased. there is new mild interstitial pulmonary edema. small bilateral pleural effusions are more conspicuous than before.
status post avr/cabg, now with discontinuation of a pleural catheter. assess for pneumothorax.
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compared to the prior radiograph there is a widened appearance to the superior mediastinum likely postoperative in nature. there is subcutaneous emphysema within the neck. there are bilateral chest tubes in place without any evidence of pneumothorax. median sternotomy wires are intact. there is mild prominence of the pulmonary vasculature consistent with mild fluid overload. linear opacities at the bases is most consistent with atelectasis.
<unk>-year-old man with thymectomy to evaluate on extension.
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there is new opacity in the retrocardiac region of left lower lobe. there is no pleural effusion or pneumothorax. cardiac silhouette is within normal size.
<unk> year old man with hemoptysis, on asa and clopidogrel. // any changes?
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a right internal jugular central venous catheter terminates immediately upstream of the cavoatrial junction. the cardiac, mediastinal and hilar contours appear stable. there is no pleural effusion or pneumothorax. the lung volumes are low. the lungs appear clear.
central line placement.
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there is no evidence of pneumonia. there is mild cardiomegaly but no pulmonary edema. there are no large pleural effusions and there is no pneumothorax. pacemaker leads end in the right atrium and right ventricle. no change from the prior study in <unk>.
<unk>-year-old with upper abdominal pain, please assess for pneumonia.
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the prior exam, there is a new opacity at the left base, concerning for pneumonia or aspiration. no other opacity is identified. there is no pulmonary edema, pleural effusion, or pneumothorax. the mediastinal contours are normal. the heart is moderately enlarged, and unchanged in the prior exam. changes from a prior cabg are noted. sternal wires are intact. again, there is extensive osteolysis of the distal left clavicle, right first rib, and left lateral ribs, similar to the prior exam. the left humerus is deformed, and unchanged from prior radiographs. this is consistent with an old fracture with significant callous formation.
chest pain and fever. evaluate for pneumonia.
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symmetric bilateral opacifications with lower lobe predominance, increased from previous examination without significant cardiomegaly.
<unk> year old man with chf, acute sob. // pulmonary edema
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endotracheal tube tip is <num> cm above the carina and is normal. right-sided picc line tip is at mid svc. both lung volumes are low. bilateral small effusions and accompanying bibasilar atelectasis, left side more than right side have not really changed much since <unk>. previously positioned left-sided pigtail catheter has been removed. no pneumothorax. cardiomediastinal silhouette is unremarkable.
<unk>-year-old man with respiratory failure, to rule out underlying pulmonary infiltrates.
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the lungs are well expanded and clear. there is mild cardiomegaly. upper mediastinal and hilar contours are unremarkable. there is no pleural effusion or pneumothorax.
<unk>-year-old female, with atypical chest pain.
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pa and lateral chest radiograph were provided. lungs are clear bilaterally. cardiomediastinal and hilar contours are within normal limits. there is no evidence of pulmonary edema or pleural effusion. there is a small left apical pneumothorax. no air under the right hemidiaphragm is identified.
<unk>f with cp x <num>d, concern for l ptx at osh // eval for pneumothorax
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ap upright and lateral views of the chest provided. lung volumes are low limiting assessment. cardiomegaly is again noted with hilar congestion and mild pulmonary edema. no large effusion is seen. no convincing evidence for pneumonia. no pneumothorax. bony structures are intact. no free air below the right hemidiaphragm.
<unk>m with return visit for cough, subjective fever
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lung volumes are relatively lower than the prior study. no definite focal consolidation is seen. there is no pleural effusion. the small right-sided pneumothorax seen on preceding chest ct, earlier today, is not appreciated on this radiograph. the cardiac and mediastinal silhouettes are unremarkable. multiple right-sided rib fractures were better assessed on preceding ct.
history: <unk>f with rib fx, ptx // eval for ptx extent
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the patient is status post median sternotomy and cabg. left-sided pacemaker device is noted with leads terminating in the right atrium and right ventricle. heart size remains mildly enlarged. the mediastinal and hilar contours are unchanged. there is mild to moderate pulmonary edema, which appears minimally improved compared to the previous exam. small bilateral pleural effusions are re- demonstrated. no pneumothorax is identified. no acute osseous abnormalities seen.
dyspnea.