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compared to the prior study, the lines and tubes have been removed. there are low inspiratory volumes. the cardiomediastinal silhouette is unchanged. again seen is patchy opacity at the left base, with air bronchograms. this appears slightly more pronounced than on the prior study, with some interval obscuration of the left hemidiaphragm and new opacity along the left chest wall. the right infrahilar patchy opacity is similar to the prior film. mild vascular plethora is more pronounced.
<unk> year old woman with respiratory failure of unknown etiology // eval for interval change
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evaluation is slightly limited due to patient rotation and low inspiratory lung volumes. the cardiac silhouette size is top normal. mild widening of the mediastinum is stable and likely related to vessel engorgement. mild pulmonary vascular congestion and pulmonary edema is unchanged. bibasilar opacities on the left greater than the right are slightly improved from the most recent prior study, possibly reflecting atelectasis. a small left pleural effusion cannot be entirely excluded. no significant right pleural effusion is detected. an endotracheal tube is in standard position. a right picc line is unchanged with the tip terminating in the mid-to-low svc. a nasogastric tube is seen coursing below the diaphragm and out of view on this image.
ng tube placement.
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prior right-sided central venous catheter is no longer visualized. relatively low lung volumes are noted. there is no confluent consolidation or large effusion. there is pulmonary vascular congestion without overt edema. cardiac silhouette is mildly enlarged, unchanged. no acute osseous abnormalities.
<unk>f with dka // eval for infiltrates
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frontal and lateral chest radiographs demonstrate clear lungs. there is mild interstitial abnormality, which is not significantly changed compared with prior. the pulmonary vasculature appears normal. the cardiac silhouette is normal in size, the mediastinal contours are normal. a small calcified probable granuloma is again noted in the left upper lobe. <unk>% vertebral body height loss of a thoracic vertebral body is again noted, and unchanged. there is prior fracture deformity of posterior left seventh rib, unchanged.
<unk>-year-old female with right-sided weakness, history of cva, please rule out infectious process.
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right-sided dialysis catheter again terminates at the lower svc/ cavoatrial junction slightly more proximal in position as compared to the prior study. . patchy left base retrocardiac opacity this could be due to atelectasis, infection, are aspiration. no large pleural effusion is seen. there is no pneumothorax. the cardiac and mediastinal silhouettes are stable. no pulmonary edema is seen.
<unk> year old man esrd, hd, presumed line infection (coag neg staph) s/p replacement line with low grade fever, new tachypnea, productive cough // r/o pna, acute process
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the lungs are clear. there is no focal consolidation, effusion, or edema. the cardiomediastinal silhouette is within normal limits. surgical clips seen in the neck. no acute osseous abnormalities.
<unk>f with acute onset left arm pain/tingling at <num>am // any cpd
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the cardiac, mediastinal and hilar contours are normal. lungs are clear. pulmonary vasculature is normal. no pleural effusion or pneumothorax is seen. no acute osseous abnormalities are visualized. no subdiaphragmatic free air is present.
shortness of breath, recent colonoscopy.
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a right internal jugular catheter is present with the tip in the upper svc. a left-sided chest tube is in unchanged position. sternal wires are intact. since the prior exam, the endotracheal tube and nasogastric tube have been removed. the lung volumes are lower, accentuating the bronchovascular structures and pleural effusions. small-to-moderate bilateral pleural effusions are likely just slightly increased in szie. there is associated atelectasis. the apices of lungs are clear. the mediastinal contours are unchanged, with an expected postoperative appearance. the cardiac size is difficult to evaluate given the adjacent effusions.
status post cabg. evaluate for effusion.
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frontal and lateral views of the chest. the lungs are clear. there is no effusion nor pneumothorax. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormality detected.
<unk>-year-old female with substernal chest pressure.
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the lungs are clear without focal opacity, pulmonary edema, pleural effusion or pneumothorax. the cardiac and mediastinal contours are normal. there is no free air beneath the right hemidiaphragm.
<unk> year old woman with cough x <num> weeks, eval for interstitial changes
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poor visualization of left hemidiaphragm and retrocardiac lung markings. the cardiac contour is stable, and nasogastric tube is unchanged in position from previous abdominal radiographs. abdominal surgical <unk> are seen consistent with recent gastric surgery.
<unk>-year-old with gastric cancer, status post subtotal gastrectomy. pneumonia versus atelectasis with patient developing new fevers.
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the cardiomediastinal and hilar contours are within normal limits and unchanged. the heart is normal in size. there is a small to moderate left pleural effusion, which has increased since the prior examination. opacity at the left base most likely represent adjacent atelectasis however superimposed infection cannot be excluded. also seen is opacification of the left upper lobe, which has improved since the prior study. a subtle opacity in the right mid lung is concerning for an additional focus of pneumonia. a small right pleural effusion is stable.
<unk> year old woman with multilobe pna and left pleural effusion. s/p thoracentesis on <unk> and <unk>. // please eval interval pna and left effusion.
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pa and lateral chest radiograph demonstrates clear lungs bilaterally. cardiomediastinal and hilar contours are within normal limits. there is no pleural effusion or pneumothorax. visualized osseous structures are without any acute abnormality.
<unk>f with cough // question of pneumonia
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pa and lateral views of the chest are compared to previous exam from <unk>. as on prior, there are increased interstitial markings seen at the lung apices bilaterally. given chronicity of these findings, they are most suggestive of chronic lung disease. mild bibasilar atelectasis is identified. there is no confluent consolidation or effusion. cardiac silhouette is enlarged but stable compared to prior. osseous and soft tissue structures are unchanged.
<unk>-year-old female with chest pain. question pneumonia or pneumothorax.
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endotracheal tube tip <num> cm above carina. moderate gastric distention. normal heart size, pulmonary vascularity. no effusion. lungs clear. no pneumothorax.
<unk> year old woman with brain mass, intubated // ett placement
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ap and lateral views of the chest are compared to previous chest x-ray from <unk>. linear opacity in the right mid lung is suggestive of scarring. increased interstitial markings are seen throughout the lungs including the left upper lung and lung bases. increased density in retrocardiac region is compatible with moderate hiatal hernia. no large effusion. cardiac silhouette is otherwise unremarkable. dense atherosclerotic calcifications noted at the arch. osseous and soft tissue structures are grossly unremarkable.
<unk>-year-old female with fever. question pneumonia.
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opacities overlying the entire right hemithorax are not substantially changed, again consistent with combination of effusion and consolidation. mild deviation of the mediastinum to the right suggests atelectasis as well. parenchymal opacities in the left lower lobe are also concerning for pneumonia. cardiac size is grossly normal.
<unk>-year-old man with possible empyema.
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heart size is normal with unremarkable cardiomediastinal silhouette and hilar contour. a right subclavian infusion port is unchanged in position with the catheter tip projecting over the right atrium. again appreciated are linear opacities in the right lower lung and left mid lung likely representative of atelectasis along with an elliptical consolidation in the left mid lung likely representing change in configuration of atelectasis otherwise without effusion or pneumothorax. left humeral head fixation hardware is incompletely imaged.
multiple myeloma; postop day pattern status post left humeral fracture repair with persistent low-grade temperature.
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pa and lateral views of the chest. the lungs are clear. the cardiomediastinal silhouette is within normal limits. there is no radiopaque foreign body identified. there is no evidence of pneumomediastinum. no acute osseous abnormality is detected.
<unk>-year-old female with likely food impaction, question foreign body. question pneumomediastinum. chest pain.
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frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and fairly well-aerated lungs without focal consolidation, pleural effusion, or pneumothorax. the visualized upper abdomen is unremarkable.
evaluate for acute cardiopulmonary process in a patient with chest pain and dyspnea.
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chronic scarring of the right lung apex and left upper lung again seen. there is minimal decrease in other bilateral pulmonary opacities since the prior study. basilar atelectasis is noted. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are grossly stable.
history: <unk>f with productive cough // pna?
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the inspiratory lung volumes remain very low with resultant accentuation of cardiomediastinal and bronchovascular structures. the right-sided port-a-cath terminates in the proximal right atrium or cavoatrial junction. there is calcification in the aortic knob. there is no large pleural effusion or pneumothorax identified on this single semi-erect view. the bones are diffusely sclerotic with mixed areas of osteolysis, consistent with known metastatic breast cancer. prominent retrocardiac density is consistent with a large hiatal hernia seen on the abdominal ct of <unk>.
<unk> year old woman with metastatic breast carcinoma, now with ?decreased breath sounds on r // ?r sided pathology
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since the chest radiograph obtained <num> days prior, no significant changes are identified. moderate to severe cardiomegaly is unchanged. there is no pulmonary vascular congestion, pulmonary edema, or pleural effusion. lungs are fully expanded and clear. cardiomediastinal and hilar silhouettes and pleural surfaces are normal.
<unk> year old woman with low grade fever and afib with rvr // eval for consolidation
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the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.
history: <unk>f with lower chest pain // ? ptx
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the heart is not enlarged. no chf, focal infiltrate, effusion, or pneumothorax is detected. within the limits of plain film radiography, no hilar mediastinal lymph nodes or pulmonary nodule is detected. minimal linear atelectasis or scarring at the left lung base laterally is noted. there are mild degenerative changes of the thoracic spine.
history: <unk>f with chest pain // ?cause of chest pain
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there is now complete opacification of the right hemi thorax and leftward shift of the mediastinal structures. on the prior chest radiograph, there was a small amount of aeration in the right upper lung, this is no longer seen. known left pulmonary nodules are better seen on ct. no pneumothorax is seen.
history: <unk>f with large r pleural effusion // eval pleural effusion
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pa and lateral views of the chest provided. suture material is seen projecting over the right mid lung as on prior. volumes are low limiting assessment. there is background emphysema without focal consolidation, large effusion or pneumothorax. cardiomediastinal silhouette appears unchanged with top-normal heart size. imaged bony structures appear grossly intact though diffusely demineralized.
<unk>f with confusion // eval for pna
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the lungs are well-expanded and clear. the cardiomediastinal and hilar contours are unchanged. there is no pneumothorax, pleural effusion, or consolidation.
history: <unk>m with cough // eval for pna
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as compared to the prior examination dated <unk>, there has been no relevant interval change. there is no consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. the cardiac silhouette is within normal limits.
<unk>m with chest pain // eval heart and lungs.
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there are bilateral diffuse interstitial opacities, predominantly upper lobes, consistent with severe pulmonary edema. however, underlying consolidation or superimposed infectious process is not cannot be excluded. heart size is at the upper limits of normal. no acute fractures are identified.
hypoxia.
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cardiac silhouette size remains mild to moderately enlarged with a large hiatal hernia again noted. the aorta remains tortuous, and mediastinal contours similar. hilar contours are normal. pulmonary vasculature is not engorged. lungs are clear apart from minimal atelectasis at the lung bases. no pleural effusion or pneumothorax is present. degenerative changes of the imaged thoracolumbar spine are again noted with bridging osteophytes.
history: <unk>f with history of asthma, copd, paf, now with worsening shortness of breath and chest pain
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heart size is normal. the mediastinal and hilar contours are normal. previously noted right paramediastinal mass is no longer visualized on the current study. 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 left arm weakness, stroke symptom, concern for infection
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ap portable upright view of the chest. vp shunt tubing crosses the right neck and hemi thorax. port-a-cath again seen residing over the right chest wall with catheter tip in the low svc. lung volumes are low with bibasilar atelectasis. no pneumothorax or large effusion. no overt edema. difficult to exclude mild congestion. heart size cannot be readily assessed. mediastinal contour is normal. bony structures are intact.
<unk>m with chest pain, severe // ? ptx
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pa and lateral chest radiograph demonstrates clear lungs bilaterally. cardiomediastinal and hilar contours are within normal limits. there is no evidence of pleural effusion, pulmonary edema, or pneumothorax. imaged upper abdomen is unremarkable.
history: <unk>f with pneumonia two weeks ago, improved, now worsened. // assess for infiltrate
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a new right internal central jugular venous catheter terminates at the upper superior vena cava. there is no evidence for pneumothorax. the heart is moderately enlarged, as before, and the patient is status post coronary artery bypass graft surgery. there is new patchy opacification of the left lung base, suspected to represent a combination of pleural effusion and atelectasis. the right lung remains clear.
central line placement after recent sigmoid colectomy.
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multifocal consolidations in the right lung have worsened. cardiac size is top-normal. et tube is in standard position. ng tube tip is out of view below the diaphragm. there is no pneumothorax
<unk> year old man with legionella pna // placement of ett
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heart size is top normal. cardiomediastinal silhouette and hilar contours are stable. there is mild central pulmonary vascular congestion with minimal interstitial reticulation, slightly increased from prior exam, compatible with mild pulmonary edema. there are tiny layering bilateral pleural effusions with a small amount of fluid layering in the fissures. a left-sided subclavian stent is unchanged. there is no pneumothorax.
chest pain.
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the previously seen right lung opacity has now resolved. the rounded opacity adjacent to the right heart border is consistent with the previously demonstrated pericardial cyst. top normal heart size with normal mediastinal and hilar contours. no pleural effusion or pneumothorax.
<unk> year old woman with recent pneumonia at <unk> // ? resolution
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the bones are diffusely sclerotic worrisome for prostate cancer metastatic disease. given this, no definite focal consolidation is seen. there is no pleural effusion or pneumothorax. the aorta is calcified and tortuous. the cardiac silhouette is top-normal.
history: <unk>m with confusion // eval for pneumonia
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ap and lateral views of the chest. the lungs are clear of focal consolidation, effusion or pneumothorax. there is no evidence of pneumomediastinum. the cardiomediastinal silhouettes within normal limits and again coronary artery stents are noted. atherosclerotic calcifications seen at the aortic arch. no acute osseous abnormalities identified. no free intraperitoneal air.
<unk>-year-old female with nausea and vomiting.
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mild interval improvement of right upper lobe consolidation. the right lower lung opacifications are unchanged. stable appearance of linear atelectasis or scarring in the left mid-lung zone. no new consolidations are identified. normal appearance of the cardiomediastinal silhouette. no evidence of pleural effusions or pneumothorax. port-a-cath is unchanged.
<unk> year old woman with asthma, pneumonia, now with worsening dyspnea // please eval for progression or resolution of pneumonia, trying to determine if infectious vs asthma driver
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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. no subdiaphragmatic free air is present.
history: <unk>m with severe sudden abdominal pain, guarding rigid abdomen
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left-sided pacemaker with leads terminating in the right ventricle and right atrium is in unchanged position. increased lower lung opacities in more of a ground glass pattern are the likely pulmonary edema superimposed on background emphysema. no pleural effusion. no focal consolidations worrisome for pneumonia.
<unk>-year-old man with chest pain, status post pacemaker, presenting with vomiting x<num> and intermittent chest pain and shortness of breath. evaluate for pneumonia.
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ap and lateral views of the chest were reviewed and compared to the prior study. the leads of a left pectoral pacer follow their expected courses to the right atrium, right and left ventricles. small left pleural effusion and mild left basilar atelectasis are unchanged. otherwise, the lungs are clear without pulmonary edema or vascular engorgement. there is no pneumothorax. moderate-to-severe cardiac enlargement is chronic.
evaluation of pacemaker lead placement.
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there has been a slight interval increase in pulmonary vascular congestion without frank interstitial edema. there is bibasilar atelectasis. there is no pneumothorax. there are no pleural effusions. there are no focal consolidations. there is a left-sided chest tube which abuts the mediastinum. the heart size is top normal.
<unk>-year-old female status post left lower lobe vats resection, who presents for evaluation of a pneumothorax.
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low lung volumes are present. cardiac silhouette size is moderately enlarged but similar. mediastinal and hilar contours are unchanged. low lung volumes result crowding of bronchovascular structures. there is no overt pulmonary edema. no large pleural effusion or pneumothorax is seen. bibasilar atelectasis is noted. no acute osseous abnormalities detected. diffuse demineralization of the osseous structures with mild degenerative changes are again noted throughout the thoracic spine. there is mild compression deformity of <num> adjacent vertebral bodies in the mid thoracic spine, unchanged.
history: <unk>f with syncope, on amiodarone
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the vagus nerve stimulator is again seen in the left chest wall, and is without evidence of lead fracture. the lungs are clear bilaterally, without focal consolidations, pleural effusions or pneumothorax. the mediastinum, hila and heart are within normal limits. mild dextroscoliosis, unchanged from prior. no acute osseous abnormalities.
<unk> year old woman with refractory epilepsy with multiple falls sustained during seizure activity // please assess integrity of vagus nerve stimulator implanted in her left chest area with lead extending up to her vagus nerve in her neck/lower cervical area- assess for any loosened connections or fractured leads.
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lung volumes are low. streaky and linear left basilar opacities most likely atelectasis. superiorly along superior. cardiomediastinal silhouette is within normal limits for technique although difficult to assess accurately. no acute osseous abnormalities pa
<unk>m with tachypnea and hypoxia // acute process?
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there is a dual lead pacemaker/ icd device in place with leads terminating in the right atrium and ventricle, respectively. the heart is normal in size. mediastinal and high contours are unremarkable. there is no pleural effusion or pneumothorax. the lungs appear clear.
status post cardiac arrest.
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frontal and lateral views of the chest were obtained. lung volumes are low, exaggerating the cardiac silhouette, which is mildly enlarged. cardiomediastinal contours are otherwise stable. increased hazy opacity at the right lung base is compatible with an enlarged right pleural effusion, now moderate in size. adjacent linear opacities are compatible with atelectasis. prominence of the pulmonary vascular markings is compatible with vascular congestion. the wires of a atrio-biventricular left chest wall pacer terminates in similar position. sternotomy wires and mediastinal clips are intact.
fever and recent congestive heart failure. evaluate for infiltrate.
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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>f w/mediastinal widening on scout ct c-spine, please eval for mediastinal widening of cxr
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the cardiac, hilar, and mediastinal contours are normal. the pulmonary vascularity is normal. lungs are clear. no pleural effusion or pneumothorax is present. there are multiple anterior osteophytes within the thoracic spine.
chest pain.
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pa and lateral views of the chest. the lungs are clear of consolidation, effusion or pneumothorax. the cardiomediastinal silhouette is normal. no acute osseous abnormalities detected.
<unk>-year-old female with cough.
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pa and lateral views of the chest provided. interval removal of an orogastric tube. on the lateral view there is poor definition of vessels. no pneumothorax. there is significantly more free air under the right and left hemidiaphragm. small, bilateral pleural effusions and associated atelectasis are mildly worsened. hilar and cardiomediastinal contours are normal.
<unk> year old man with recent umbilical hernia repair // evaluate for progression of free air
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single frontal view of the chest was obtained. endotracheal tube terminates <num> cm above the carina. left subclavian central catheter terminates in the right atrium. heart size is top normal. low lung volumes simulates vascular congestion, and severe left lower lobe atelectasis explains leftward mediastinal shift. blunting of left costophrenic angle suggests a small left pleural effusion. interstitial abnormality at the base of the right lung, including microcalcifications, is chronic. no pneumothorax. stomach is severely distended with air and fluid; no ngt in place.
<unk>-year-old male status post cardiac arrest with endotracheal tube and left subclavian line.
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frontal and lateral radiographs of the chest demonstrate normal heart size. calcifications project over the central heart on the lateral view. the mediastinal silhouette and hilar contours are normal. the lungs are clear. no pleural effusion or pneumothorax. median sternotomy wires are intact
chest pain, evaluate for mass or pneumonia
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there is no evidence for free intraperitoneal air or pneumomediastinum. heart and mediastinal contours are within normal limits. no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen on this single frontal view.
<unk>-year-old male with hematemesis and abdominal pain.
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lungs are well-expanded and clear. cardiomediastinal and hilar contours are unremarkable. there is no pneumothorax, pleural effusion, or consolidation.
history: <unk>m with leukocytosis // leukocytosis
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heart size is normal. mediastinal and hilar contours are unremarkable. moderate size right pleural effusion appears minimally decreased in size compared to the prior study. small left pleural effusion appears almost completely resolved. bibasilar airspace opacities likely reflect atelectasis. pulmonary vasculature is not engorged. no pneumothorax is identified. there are no acute osseous abnormalities.
history: <unk>f with shortness of breath
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the lungs are hypoinflated with crowding of vasculature. heterogeneous right lower lobe opacity is most consistent with atelectasis. no pleural effusion or pneumothorax. persistent mild cardiomegaly is noted. mediastinal contour and hila are unremarkable.
<unk>f with chest pain. assess for pna, effusion, infection
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the lungs are well expanded and clear. the cardiomediastinal silhouette, hilar contours, pleural surfaces are normal. there are no focal opacities to suggest pneumonia. there is no pleural effusion or pneumothorax.
woman with cough. rule out pneumonia.
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heart size is moderately enlarged, unchanged. 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 right upper extermity pain
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portable ap upright chest radiograph was obtained. the lungs appear clear. there is no pleural effusion or pneumothorax. the heart is normal in size with dual lead pacemaker device in conventional position and normal cardiomediastinal contours.
syncope and tachycardia, cyst or edema or pneumonia.
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the lungs are clear. there is no pneumothorax. the heart and mediastinum are within normal limits. regional bones and soft tissues are unremarkable. metallic right upper quadrant surgical clips indicate prior cholecystectomy.
<unk> year old woman with cough, fever and chronic pancreatitis. // please evaluate for infection.
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as compared to chest radiograph dated <unk>, there is improved right upper lobe atelectasis with no residual pneumomediastinum. a small right subpulmonic pleural effusion persists and is unchanged. the left lung is grossly clear. no new focal consolidation. no pneumothorax. an et tube is seen in appropriate position. the cardiomediastinal and hilar contours are stable.
<unk>-year-old female with ventilator dependent respiratory failure. evaluate interval change.
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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 pancreatitis // eval for acute process
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a small left pleural effusion and left-sided atelectasis are unchanged. there is no new opacity to suggest pneumonia. there is no pulmonary edema, right pleural effusion, or pneumothorax. cardiomediastinal silhouette is normal. post-surgical changes from a prior cabg are present. left-sided port-a-cath is noted with the tip in the upper right atrium.
relapse cll with increased cough.
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frontal and lateral views of the chest. triple lead left chest wall pacing device is again seen. the lungs remain clear. cardiomediastinal silhouette is stable. hypertrophic changes again noted in the spine.
<unk>-year-old male with shortness of breath.
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a right internal jugular central venous catheter is in the upper svc. heart size and mediastinal contours are stable. patient has emphysema. bibasilar opacities are nonspecific and could be related to infection, aspiration, or atelectasis. these opacities are worse compared to the most recent examination of <unk>, but similar to the prior examination of <unk>. there is no large pleural effusion or pneumothorax.
history: <unk>m with ij from osh // eval for line placement
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there are scattered areas of nodular opacity in the right upper and left mid lung. findings are most likely representative of pneumonia though follow-up to resolution is advised. no large effusion or pneumothorax. the cardiomediastinal silhouette is unchanged. there is no pleural effusion or pneumothorax.
<unk>f vomiting and new ams, with cirrhosis of the liver. evaluate for infectious process.
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et tube is <num> cm above level of carina and below the superior aspect of the clavicles. end of ng tube is in stomach and out of view. right picc tip is in low svc. right ij hemodialysis tip is in low svc, approximately <num> cm superior to right picc tip. mild decrease in severe bilateral pulmonary opacities with air bronchograms with mild improvement in lung volumes. no pleural effusion or pneumothorax. heart size is mildly enlarged with normal mediastinal contour.
<unk>-year-old female with ascites and cirrhosis. assess pulmonary edema.
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pa and lateral views of the chest are compared to previous exam from <unk>. compared with prior, there has been no significant interval change. the lungs remain clear. there is no pleural effusion. there is no pulmonary vascular engorgement. cardiac silhouette is enlarged, but stable in configuration. biventricular pacing device again seen with multiple leads in stable positions. atherosclerotic calcifications seen throughout the aorta. median sternotomy wires and mediastinal clips again noted.
<unk>-year-old female with chest pain. history of congestive failure. question pulmonary edema.
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the patient is status post coronary artery bypass graft surgery. the heart is mildly enlarged. there is patchy left basilar opacity which may represent pneumonia, but atelectasis and pleural effusion could also be considered. a pleural effusion is suspected but not well demonstrated. elsewhere, the lungs appear clear. there is no pneumothorax or evidence for pleural effusion on the right.
elevated troponin. prior history of cabg. concern for pneumonia as well.
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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.
<unk>m w/chest pain, please eval for ptx // <unk>m w/chest pain, please eval for ptx
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frontal and lateral chest radiograph demonstrateswell expanded lungs with left lower lobe atelectasis. no pleural effusion or pneumothorax. heart is mildly enlarged, unchanged from previous examination. tortuous aorta is noted. mediastinal contour, and hila are otherwise unremarkable. limited assessment of the upper abdomen is within normal limits.
cough. assess for pneumonia.
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there is emphysema and the lungs are hyperinflated. a linear opacity contacting the pleural surfaces again seen in the right upper lobe. available outside hospital reports (atrius), most recently performed in <unk>, described stability since <unk>. nipple shadows should not be mistaken for nodules. no focal consolidation worrisome for pneumonia. no pleural effusion or pneumothorax. heart is normal size and there is no pulmonary edema. mediastinal and hilar contours are unremarkable.
palpitations. evaluate for pneumonia.
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the lungs are well expanded and clear. there is no pleural abnormality. the cardiomediastinal silhouette is unchanged compared to prior. surgical clips are seen at the left hilum, unchanged from prior. median sternotomy wires are aligned and intact. gastric band is partially visualized.
<unk> year old man with long smoking history, htn, hyperlipidemia, cad // on abdominal ct rml nodule noted. wish to better characterize this region. no pulmonary symptoms. recent prolonged bout with diverticulitis
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frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. the lungs are clear. there is no pneumothorax, vascular congestion, or pleural effusion.
<unk>-year-old female with pancreatitis. question pleural effusion.
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the cardiomediastinal silhouette is normal. the hila and pleura are unremarkable. interval improvement of previous left lower lobe opacity is seen. no new focal opacifications, pleural effusions, pulmonary edema, or pneumothorax are seen.
<unk> year old man with copd and recent lll pneumonia // assess for pneumonia clearance
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the patient is status post median sternotomy and aortic valve replacement. the heart is normal in size. the aorta is mildly unfolded. the mediastinal and hilar contours are otherwise unremarkable, and the pulmonary vasculature is normal. no pleural effusion, focal consolidation or pneumothorax is present. nodular opacity projecting over the lateral aspect of the right upper lung field correlates to a pleural plaque, as demonstrated on the prior ct.
chest pressure, sweats, possible bacterial endocarditis.
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the lung volumes are low. there is an opacity in the left lower lobe which may be atelectasis or pneumonia in the appropriate clinical setting. the cardiomediastinal hilar contours are normal. the pleural surfaces are normal. the catheter a left vp shunt is seen traversing the diaphragm however the ends are beyond the margin of this image. stable advanced degenerative disease of the left shoulder with an unchanged osseous loose body in left axilla.
<unk> year old man s/p vp shunt placement with fevers to <num> // evaluate for pna
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the cardiac, mediastinal and hilar contours are normal. the pulmonary vascularity is normal. the lungs are clear. no focal consolidation, pleural effusion or pneumothorax is present. clips from prior thyroidectomy are seen within the neck. there are no acute osseous abnormalities.
thyroid cancer status post thyroidectomy with chest pain for the last <num> days and shortness of breath the last day.
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portable ap upright chest film <unk> at <time> is submitted.
<unk> year old man with inability to tolerate po diet s/p dobhoff placement. // dobhoff position. dobhoff position.
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frontal and lateral views of the chest were obtained. the heart is of normal size with normal cardiomediastinal contours. atriobiventricular leads of a left chest wall pacer terminate in similar position to <unk>. sternotomy wires are intact. multiple mediastinal clips are similar to prior. lung volumes are low. lungs are otherwise clear without focal or diffuse abnormality. no pleural effusion or pneumothorax. chronic right rib deformities are similar to prior. acromioclavicular joint arthropathy is present bilaterally.
<unk>-year-old male with chest pain. evaluate for chf or pneumonia.
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endotracheal tube terminates <num> cm above the level of the carina. enteric tube courses below the diaphragm, terminating in the left upper quadrant. the side port appears to be at the level of the ge junction. consider advancement so that it is well within the stomach. no definite focal consolidation is seen. there is no pleural effusion or pneumothorax. the cardiac silhouette is top-normal. mediastinal contours are grossly unremarkable. areas of osseous sclerosis are consistent with reported history of prostate metastatic disease.
intubated // confirm ett
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the heart is normal in size. the mediastinal and hilar contours appear stable. there is no pleural effusion or pneumothorax. the lungs appear clear. bony structures appear within normal limits.
chest pain.
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heart is normal size and cardiovascular silhouettes is stable. lungs are clear. there is no pleural effusion or pneumothorax.
<unk> year old man with <num> weeks of cough, shortness of breath and sweats. // r/o pneumonia
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there is stable mild cardiomegaly. there is mild the towards thoracic aorta, unchanged. the hila are within normal limits. bibasilar opacities are similar appearance to prior exam and suggestive of linear atelectasis. there is no pulmonary vascular congestion or pulmonary edema. there may be a small right pleural effusion. no left pleural effusion. there is no pneumothorax.
<unk>m with copd with new dyspnea, evaluate for pneumonia.
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the lungs are hyperinflated, consistent with known emphysema. opacity is again seen within the right upper lobe compatible with known malignancy with a fiducial marker identified. there is increased opacity adjacent to tumor, most likely representing post-obstructive infection or atelectasis. there is a new patchy opacity in the right lung base, which likely represents infection. bibasilar atelectasis or scarring is seen. the cardiomediastinal silhouette is unremarkable. sclerotic lesion in the left humeral head is unchanged from <unk>, likely representing medullary infarct or enchonroma. a stable bone island is seen in the left glenoid.
shortness of breath.
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there are low lung volumes. no focal consolidation concerning for pneumonia. there is no pneumothorax or pleural effusion. the pulmonary vasculature is not engorged and there is no evidence of pulmonary edema. the heart is enlarged, however, it is returning to preoperative appearance. remnant epicardial leads are seen projecting over left lower lobe. sternotomy wires are intact.
<unk>-year-old male patient status post redo stern with mental status changes. study requested for evaluation of pneumonia.
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inspiratory volumes are slightly low. allowing for this, the heart is not enlarged. aorta is minimally unfolded. no chf, focal infiltrate or pneumothorax is detected. no pleural effusion is identified. no free air seen beneath the diaphragms. a nodular density measuring approximately <num> mm in maximal diameter is noted at the right lung base laterally. this is in keeping with findings on the previous chest x-rays and with the calcified granuloma identified at the right lung base on the <unk> abdominal ct. it does now measure slightly larger than on the <unk> chest x-ray (at which time it measured <num> mm maximal diameter), but was clearly calcified on ct scan this could be due to technical differences.
history: <unk>f with acute pancreatitis // evaluate for pleural effusion
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the lungs are clear without focal consolidation, effusion, or vascular congestion. there is moderate cardiomegaly. no acute osseous abnormalities identified.
<unk>m with palpitations // infiltrate?
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the lung volumes are stable. the increased opacification of the right lower lung, which was of concern on earlier study, has improved and was likely due to pulmonary edema rather than an infectious consolidation. mild improvement of pulmonary edema. stable moderate cardiomegaly. the pleural surfaces are stable. the ng tube is located near the esophagogastric junction. the right ij terminates in the lower svc.
<unk> year old woman with ngt // anesthesia attending here bedside needs stat
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lung volumes are low. there is opacification of the right lower lobe silhouetting the diaphragm. the lungs are otherwise clear. there is severe cardiomegaly with unchanged mild pulmonary vascular congestion but no pulmonary edema. cardiomediastinal hilar silhouettes are grossly unremarkable. incidental note is made of superior subluxation of the right humeral head, which is unchanged and likely related to chronic rotator cuff pathology.
<unk>f with altered mental status.
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the endotracheal tube tip seats <num> cm above the carina. the endogastric tube courses inferiorly and out of field of view without clear visualization of the tip or side port. there has been interval placement of a right-sided ij central venous catheter with its tip in the upper-to-mid svc. otherwise, the heart size is at the upper limits of normal with mediastinal contours still compatible with central vascular engorgement. the pulmonary perihilar opacities persist; slightly improved compared to prior exam. there is no pleural effusion, pneumothorax, or apical cap. again, multiple healing rib fractures are present, primarily along the posterolateral aspect of the right thoracic rib cage.
<unk>-year-old male with new right internal jugular central venous catheter.
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there is mild cardiomegaly and tortuosity of the aorta. there is hyperinflation of the lungs, suggestive of chronic obstructive pulmonary disease. the lungs are clear. there are no focal consolidations, pleural effusions, pulmonary edema, or pneumothorax. patient is status post cabg with intact sternotomy wires.
<unk>-year-old male patient with cough. study requested to rule out infiltrate.
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the lungs are clear without focal consolidation, effusion, or edema. the cardiomediastinal silhouette is stable. tortuosity of the descending thoracic aorta is again noted. mild compression deformity of a lower thoracic vertebral body is unchanged.
<unk>f with diaphoresis and syncope pls eval pnaq
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ap upright and lateral views of the chest were obtained. a chest tube is again noted at the right base. there is a persistent small right apical pneumothorax, not significantly changed compared to the prior examination. lungs are clear. cardiomediastinal silhouette is stable. there is no pleural effusion. patient is status post mitral valve replacement.
<unk>-year-old man with mitral valve replacement, postoperative day <num>, evaluate for pneumothorax, chest tube on waterseal.
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the lungs are clear without overt pulmonary edema or large effusion. cardiac silhouette is enlarged but stable. left chest wall single lead pacing device, median sternotomy wires and mediastinal clips are again noted.
<unk>m with significant cardiac history presenting with <unk> swelling, dyspnea on exertion // eval for fluid overload
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endotracheal tube tip is approximately <num> cm from the carina. enteric tube seen with tip in the region just proximal to the gastroesophageal junction and should be advanced. right chest wall port catheter tip in the right atrium. low lung volumes are noted however the lungs are grossly clear. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
<unk>m with h/o gbm with new type of seizure and status epilepticus. intubated in the field