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the lungs are clear without focal consolidation, effusion, or edema. cardiomediastinal silhouette is stable with an appearance which suggests prominent mediastinal fat. no acute osseous abnormalities.
<unk>f with sob, feels like her asthma attacks, pls eval pna or effusion
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frontal and lateral radiographs of the chest again demonstrate thoracic spinal stabilization. the lungs are clear. the cardiac and mediastinal contours are normal. no pleural abnormality is seen.
positive ppd. rule out tb.
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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 shortness of breath
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pa and lateral chest views were obtained with patient in upright position. analysis is performed in direct comparison with the next preceding similar study of <unk>. the previously described mild degree of cardiac enlargement persists. there is no typical configurational abnormality; however, the left ventricular contour is relatively prominent. again noted is an upper zone pulmonary vascular redistribution pattern indicative of mild pulmonary congestion, but there are no signs of advanced interstitial or alveolar edema. also, the lateral and posterior pleural sinuses are free from any pleural effusion. no discrete local parenchymal infiltrates can be identified. no pneumothorax exists in the apical area on frontal view. skeletal structures of the thorax remain grossly unremarkable.
<unk>-year-old male patient with cough and rhonchi on left side. evaluate.
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the cardiac, mediastinal and hilar contours are normal. lungs are clear. the pulmonary vasculature is normal. no pleural effusion or pneumothorax is present. no acute osseous abnormalities are present. there are clips noted in the upper abdomen.
cough, shortness of breath.
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the cardiac, mediastinal and hilar contours appear unchanged. there is a persistent diffuse mild interstitial abnormality. this appearance suggests mild vascular pulmonary edema but is less striking than on the prior radiographs. in addition a lingular opacity is seen in two views but better depicted on the frontal view. there is no definite pleural effusion or pneumothorax.
hypotension.
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lung volumes are low. lungs are clear. small left pleural effusion is unchanged. no pneumothorax. heart size is normal. cardiomediastinal and hilar silhouettes are normal. a right ij port-a-cath terminates in the low svc. a left picc terminates near the expected location of the superior cavoatrial junction.
<unk>f with right upper quadrant pain, history of gastric ca.
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cardiomediastinal contours are normal. pacer leads are in standard position with tips in the right atrium and right ventricle. the lungs are clear. there is no pneumothorax or pleural effusion. the osseous structures are unremarkable
<unk> year old man s/p atrial lead revision // <unk> year old man s/p atrial lead revision
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the lungs are hyperinflated but clear of consolidation. there are small bilateral pleural effusions. there is no evidence of pulmonary vascular congestion. cardiomediastinal silhouette is within normal limits, noting atherosclerotic calcifications at the arch. osseous and soft tissue structures are notable for posterior fixation hardware in the lumbar spine which is partially visualized.
<unk>-year-old male with acute renal failure. question chf.
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left-sided port-a-cath tip terminates at the junction of the svc and right atrium. heart size is normal. mediastinal and hilar contours are unremarkable. pulmonary vascularity is normal. lungs are clear. no pleural effusion or pneumothorax is present. no acute osseous abnormalities are detected.
fever and neutropenia.
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two portable frontal chest radiographs were obtained. a nasoenteric tube coils once in the fundus of the stomach and extends inferiorly. the right internal jugular catheter tip is at the cavoatrial junction. lung volumes are low which accentuates the pulmonary vasculature. no new consolidation, effusion, or pneumothorax is present.
<unk>-year-old man with hypothermia, altered mental status, status post <num>-cm retraction of nasogastric tube.
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the lungs are well inflated and clear. no consolidation, effusion, or pneumothorax is present. the heart and mediastinal contours are normal.
<unk>-year-old man with palpitations, chest tightness, evaluate for pneumothorax.
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a dual-lead pacemaker/icd device has leads terminating in the right atrium and ventricle, respectively. the cardiac, mediastinal and hilar contours appear stable. the lungs appear clear. there no pleural effusions or pneumothorax. a moderate lower thoracic compression appears unchanged.
left scapular and upper back pain.
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right-sided port-a-cath tip terminates at the svc/right atrial junction. heart size is normal. the aorta remains tortuous. mediastinal and hilar contours are otherwise unchanged. subsegmental atelectasis is noted in the left lower lobe. remainder of the lungs are clear. no focal consolidation, pleural effusion or pneumothorax is seen. unchanged compression deformities are again noted within the mid and lower thoracic spine.
history: <unk>m with arthralgia, cough
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the patient is status post median sternotomy and cabg. cardiac, mediastinal and hilar contours are unremarkable, and the heart size is within normal limits. mild atherosclerotic calcifications are noted at the aortic arch. scattered calcified nodules are compatible with granulomas, unchanged. no focal consolidation, pleural effusion or pneumothorax is visualized. no displaced fractures are seen. there are mild degenerative changes in the thoracic spine.
right-sided chest pain.
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the lung volumes are low, resulting in crowding of the bronchovascular structures. bibasilar opacities are present. there is no pleural effusion, pneumothorax or focal airspace consolidation. heart is top normal size. the mediastinal and hilar contours are unremarkable.
hypoxia. evaluate for pneumonia.
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normal heart size, mediastinal and hilar contours. no focal consolidation, pleural effusion or pneumothorax. note is made of mild rightward convex scoliosis centered at t<num>.
history: <unk>f with cp // eval for ptx
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normal heart size, mediastinal and hilar contours. stable tortuosity of the thoracic aorta. no focal consolidation, pleural effusion or pneumothorax. unchanged calcified <num> mm granuloma in the right lower lobe. the trachea is deviated to the left likely by the known thyroid goiter, unchanged from prior.
history: <unk>f with htn urgency, occasional sob // ? infiltrate, cardiac silhouette
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portable chest radiograph demonstrates unchanged mediastinal, hilar, and cardiac contours. a right-sided subclavian catheter whose tip at the cavoatrial junction. lungs are clear. no pleural effusion or pneumothorax evident. on this non-dedicated rib series, no grossly displaced rib fractures evident.
osteoporosis, on chronic steroid use, complaining of pain in chest wall, please evaluate for fracture.
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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 fever // evaluate for pneumonia
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the cardiac, mediastinal and hilar contours are normal. lungs are clear and the pulmonary vascularity is normal. no pleural effusion or pneumothorax is present. no acute osseous abnormality is present.
cough.
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right picc is noted however the tip is not clearly delineated. streaky left basilar opacity is noted, likely atelectasis. prior pulmonary edema has nearly resolved. couple scattered surgical clips project over the left chest. surgical clips also noted in the right upper quadrant. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
<unk>f with hypoxia and apnea, pinpoint pupils // ?acute cardiopulmonary process
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pa and lateral views of the chest are compared to previous exam from <unk>. linear opacity at the left lung base suggestive of atelectasis, especially in the setting of lower lung volumes. elsewhere, the lungs are clear. the cardiomediastinal silhouette is within normal limits. osseous and soft tissue structures are unremarkable.
<unk>-year-old male with cough, question pneumonia.
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the tip of the endotracheal tube projects over the mid thoracic trachea. a feeding tube extends into the stomach. the tip of the left internal jugular central venous catheter projects over the mid svc. the lungs are markedly hyperexpanded. there are persisting but decreased left lower lung zone patchy opacities. blunting of both costophrenic angles are noted which may reflect small bilateral pleural effusions or pleural thickening. no pneumothorax identified. the size the cardiomediastinal silhouette is within normal limits.
<unk> year old man intubated in respiratory distress // evaluate for acute cardiopulmonary process
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<num> left chest tubes are unchanged in position, no pneumothorax. bilateral pleural effusions and bibasilar atelectasis, left greater than right are unchanged. large hiatal hernia is seen.
<unk> year old woman with pleural effusions, now s/p vats w/ <num> chest tubes in place. has pe in rll. // any changes compared to last cxr? any new consolidative process/smaller pleural effusion? any changes compared to last cxr? any new consolidative proc
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heart size top-normal. . there is no focal consolidation, pleural effusion or pneumothorax. calcified granuloma right lung is clinically is a
<unk> year old woman with dementia, asthma/copd, being treated for flare,? aspiration versus pna in thes setting of a new fever // pna, aspiration
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the lungs are well expanded and clear. the cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. there is no pleural effusion or pneumothorax.
cough x<num> weeks, bilateral upper lung field rhonchi, assess for pneumonia.
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lines and tubes: none lungs: persistent right basilar opacities with new left basilar opacities compatible with multifocal pneumonia less likely bibasilar atelectasis. pleura: there is no pleural effusion or pneumothorax mediastinum: there is no cardiomegaly. mediastinal silhoutte is within normal limits. bony thorax: diffuse osteopenia with no significant interval change.
<unk> year old woman with pneumonia and still febrile // interval change
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the cardiomediastinal silhouettes are stable, with a mildly tortuous thoracic aorta. the hila are unremarkable. the lungs are clear without focal consolidation. there is no pulmonary vascular congestion or pulmonary edema. there is no pneumothorax or pleural effusion.
<unk>-year-old woman with hypoxia, rule out acute process.
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pa and lateral chest radiographs demonstrate clear lungs bilaterally. no focal opacity convincing for pneumonia is identified. calcification projecting over the medial right lung base is stable, unchanged, likely a granuloma. there is no pleural effusion or pneumothorax. no evidence of pulmonary edema. cardiomediastinal and hilar contours are within normal limits, stable in size and configuration. no air under the right hemidiaphragm is seen.
history: <unk>f with chest pain // chest pain
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right-sided port-a-cath tip terminates in the lower svc. the cardiac, mediastinal and hilar contours are normal. the pulmonary vascularity is normal. the lungs are clear. no pleural effusion or pneumothorax is present. no acute osseous abnormalities identified.
fever, recent chemotherapy.
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there are scattered areas of atelectasis such as within the left upper lobe and no new focal opacities concerning for pneumonia. there is persistent elevation of the right hemidiaphragm. there are no pleural effusions or pneumothorax. the cardiomediastinal and hilar contours are stable with marked tortuosity of the thoracic aorta and a left ventricular configuration of the heart. pulmonary vascularity is normal. there are multiple mild wedge compression deformities with exaggerated thoracic kyphosis.
<unk>-year-old female with metastatic breast ca, admitted for tace. now with increasing dyspnea.
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the lungs are clear of focal consolidation, pleural effusion or pneumothorax. the heart size is normal. the mediastinal contours are normal.
<unk> year old male with shortness of breath.
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lung volumes are reduced. compared to the most recent exam, there is increased patchy opacity in the right lower lobe, best seen on the frontal views. left basilar atelectasis is also noted. due to the patient's kyphosis and scoliosis, the lateral views are very limited. heart size is mildly enlarged. mediastinal and hilar contours are unchanged. there is no edema, pleural effusion or pneumothorax.
<unk>-year-old man with altered mental status. question pneumonia.
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an endotracheal tube is in appropriate position ending approximately <num> cm above the carina. a nasoenteric tube tip ends in the stomach. again seen are diffuse airspace opacities, overall not likely changed compared to chest radiograph from <num> hour prior. there is no pneumothorax.
<unk>-year-old man, evaluate endotracheal tube position.
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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 with facial swelling // r/o acute process
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portable semi-upright radiograph of the chest demonstrates slight retrocardiac opacity consistent with atelectasis. there has been marked interval improvement in bilateral interstitial opacities consistent with improving pulmonary edema. the mediastinum remains widened, although has decreased slightly in size as compared to the prior. the heart is mildly enlarged. there is no pneumothorax. a chest tube projects over the right hemithorax. there is a stent in the decending thoracic aorta.
<unk>-year-old female status post cardiac surgery. evaluate for interval change.
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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 chest pain, dyspnea // acute process
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the lungs remain hyperinflated, with flattening of the diaphragms and lucency at the lung apices consistent with chronic obstructive pulmonary disease, pulmonary emphysema. no definite focal consolidation is seen. the cardiac silhouette is top-normal. the aorta is calcified. there may be minimal pulmonary vascular congestion. remote right-sided rib fractures are re- demonstrated.
history: <unk>f with cp radiating to back, +trop // evaluate for acute process, specifically evaluate aorta
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heart size is normal. mediastinal and hilar contours are unremarkable. the pulmonary vascularity is normal. apart from minimal bibasilar atelectasis, the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is visualized. multiple old bilateral rib fractures are re- demonstrated.
fall, unreliable historian.
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compared to the prior study there is no significant interval change.
<unk> year old man s/p trach with tachypnea // eval for infiltrate
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ap view of the chest provided. right-sided chest tube is seen in unchanged position. there is no pneumothorax. cardiomediastinal and hilar contours are normal. there are no pleural effusions. nasogastric tube has been removed.
<unk> year old man distended with multiple stab wounds, now with ct to water seal // evidence of pneumothorax. please perform at <unk>
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there is a right upper extremity access picc line with its tip not clearly visualized. left chest wall aicd is noted with leads extending into the region the right ventricle. cardiomegaly is again noted with hilar congestion. no large effusion or pneumothorax. bony structures are intact
<unk>m with picc s/p repositioning
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in the left mid lung, there are several focal opacities, which are new from the prior exam. these are concerning for multifocal pneumonia. no other consolidations are identified. there is no pleural effusion or pneumothorax. there is no evidence of pulmonary edema. the right hemidiaphragm is elevated and unchanged from prior exam. the cardiomediastinal silhouette is normal and also stable. no fracture is identified.
left-sided pain and cough.
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right internal jugular central venous catheter tip terminates in the upper svc. no large pneumothorax is identified on this supine exam, however the costophrenic angles bilaterally are not fully included in the field of view. remainder of the exam is unchanged with stable cardiac, mediastinal and hilar contours. persistent bibasilar opacities, likely atelectasis.
history: <unk>m with central line placement
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cardiomediastinal contours are normal. patient has multiple valve replacements. the lungs are clear. there is no pneumothorax or pleural effusion. sternal wires are aligned.
<unk> year old woman s/p valve replacement.recent onset of cough and ankle swelling // r/o chf
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the lung volumes are low, with asymmetric volume loss in the right lung from a prior right upper lobe resection. surgical changes are stable in appearance. diffuse interstitial opacities are compatible with chronic interstitial lung disease, though there are increased interstitial opacities throughout both lungs. in comparison to the prior radiograph, there is a new opacity in the retrocardiac region, concerning for infection. there is no obvious pulmonary edema, pleural effusion, or pneumothorax. the cardiomediastinal silhouette is normal.
known pulmonary fibrosis. presenting with fevers, chills, and increasing oxygen requirements.
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in comparison to the most recent prior study, there are no new changes noted. the heart is enlarged, the bibasilar plate-like atelectasis are unchanged; a dense region of linear opacity in the left midlung consistent with post biopsy bleeding and/or edema is unchanged. the port-a-cath tip is in stable position. no pneumothorax seen.
<unk> year old woman with s/p bronchoscopy with ebus biopsy // r/u ptx
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a chest tube again projects over the right hemithorax. there is a similar small quantity of associated subcutaneous emphysema along the right lateral chest wall and base of the neck. there is apparently a trace right apical pneumothorax but not substantial noting an in situ chest tube. the cardiac, mediastinal and hilar contours appear stable. increased volume loss and retrocardiac opacification are noted in the left lower lobe with a new small possible pleural effusion.
status post coronary bypass graft surgery with chest tube placement for post-operative pneumothorax.
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the lungs are clear bilaterally. no evidence of focal consolidations, effusions or pneumothorax. cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
<unk> year old man with cough for <num> weeks, productive. // r/o abnormality, pneumonia.
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frontal and lateral radiographs of the chest show asymmetric opacification at the left base in response to a retrocardiac opacification on the lateral view. in the appropriate clinical setting, this likely represents pneumonia of the left lower lobe. no other areas of focal opacification are noted. mild right basilar atelectasis is seen. no pleural effusions or pneumothorax is appreciated. the cardiac and mediastinal contours are normal and unchanged since <unk>.
dyspnea and cough. evaluate for air trapping or infection.
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the initial radiograph from <unk> shows interval placement of an endotracheal tube whose tip terminates above the clavicles. advancement by <num>-<num> cm would provide more effective ventilation. there is also new right upper lobe atelectasis with associated volume loss. the left lung is clear. the heart and mediastinum are magnified by the projection. a nasogastric tube coils in the stomach, distal tip not visualized. the follow-up radiograph from <unk> shows slight advancement of the endotracheal tube. the right upper lobe has re-expanded, but lung volumes remain low. there are new bilateral airspace opacities which are most likely due to pulmonary edema. small bilateral pleural effusions are also new. increased retrocardiac opacification is most likely due to atelectasis. heart size has increased.
<unk> year old woman with asthma s/p intubation during egd. // please eval for et tube placement and pulmonary process. <unk> year old woman with asthma s/p bronch and et tube reposition. // please eval for rul change and et tube placement.
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no pleural effusion is seen. there is no pneumothorax. cardiac silhouette is mildly enlarged. mediastinal contours are unremarkable and stable. there is increase in pulmonary vasculature bilaterally suggesting mild interstitial edema, increased as compared to the prior study. difficult to exclude underlying pulmonary nodule, and if this is of clinical concern, chest ct is more sensitive.
history: <unk>f with chf, brca p/w dyspnea and chest pain // pulm edema vs. infiltrate
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ap upright and lateral views of the chest provided. lung volumes are low though allowing for this the lungs appear clear. no definite signs of pneumonia or edema. no large effusion or pneumothorax. cardiomediastinal silhouette is normal. no acute bony abnormalities.
<unk> year old woman with seizure history here with whole body tremors // eval acute issues
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the lung volumes are overall low, there is persistent elevation of the right hemidiaphragm relative to the left side. faint increased opacity in the left lower lobe/ lingula was also present on the prior chest radiograph dated <unk> and has not changed in the interval, may represent atelectasis. there is no lobar consolidation. no pleural effusions. cardiomediastinal silhouette is unchanged. degenerative changes of the thoracic spine are as before.
history: <unk>m with persistent cough // infiltrate
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lung volumes are low accentuating the bronchovascular markings. there is no frank pulmonary edema, pleural effusions or focal consolidation. bibasilar opacities may reflect atelectasis or aspiration. the heart size is within normal limits. there is no evidence of prior pacer leads.
<unk> year old man status post percutaneous coronary intervention with drug eluting stent for inferior stemi. please evaluate for past pacer leads
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ap and lateral views of the chest provided. right pigtail catheter remains in place. moderate subcutaneous emphysema along the right lateral chest wall is new. small right pleural effusion is unchanged. small left pleural effusion is increased. moderate bibasilar atelectasis is unchanged. no pneumothorax is seen on the right. a small, left pneumothorax on the left is unchanged. hilar contours are normal. moderate cardiomegaly is stable. right upper extremity vascular catheter ends in the right axilla.
<unk>f tx from <unk> c/f large perforated icarcerated hiatal hernia found to have perforated duo now s/p l thoracotomy, hiatal hernia reduction/<num>' repair, exlap, <unk> patch, <unk> g-tube // eval effusion
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the et tube is <num> cm above the carina. there is pulmonary vascular due to redistribution and moderate cardiomegaly compatible with fluid overload. there is minimal blunting of the cp angles but no definite pleural effusion there is retrocardiac opacity with air bronchograms the right ij cordis is unchanged
<unk> year old man with arrest // ett
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the lungs are clear. no pleural abnormalities. the cardiac silhouettes is normal. mildly enlarged bilateral pulmonary arteries.
<unk> year old woman with positive ppd // ?active tb
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frontal and lateral radiographs of the chest demonstrate normal heart size, mediastinal and hilar contours. the lungs are clear. no pleural effusion or pneumothorax. an opacity projecting over the mid thoracic spine on the lateral view was demonstrated to be a large osteophyte on the prior ct.
hemoptysis, evaluate for evidence of tb, mass or pneumonia
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enteric tube tip is seen to the level of the mid stomach. postoperative changes in the upper abdomen. left ij central line tip in the upper svc. worsened right pleural effusion. worsened perihilar opacities, right basilar opacity, likely edema, possible component of atelectasis, or pneumonitis in the appropriate clinical setting. shallow inspiration obscures visualization of the heart, which has mildly increased since prior. there is small left pleural effusion, stable. stable left lower lobe consolidation, likely atelectasis. degenerative arthritis bilateral shoulders. degenerative changes spine.
<unk> year old woman with complicated pulm hx, recently extubated and tachypneic. positive fluid balance today despite good uop. // pulmonary edema
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lung volumes are low. cardiomediastinal silhouette is mild-to-moderately enlarged. there is no pleural effusion or pneumothorax. there is no focal lung consolidation. there is no pulmonary edema
<unk> year old woman with dchf coming in with sob and etoh, evaluate for pulmonary edema or aspiration.
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the lungs are clear of consolidation, effusion, or edema. there is a suspected hiatal hernia. calcific nodule projects over the right scapula, between the posterior right sixth and seventh ribs, of doubtful clinical significance. cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
<unk>f with ams // pna?
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compared to prior, there is improvement of the diffuse airspace disease. right upper and lower lobe opacities are likely residual pulmonary edema. no appreciable pleural effusion is seen. there is mild decrease in cardiomegaly, and the mediastinal and hilar contours. there has been interval removal of swan-ganz catheter. no pneumothorax is seen. biapical thickening is unchanged.
<unk> year old man with chf, s/p cordis removal // evaluation of pulmonary edema
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the cardiomediastinal silhouette is normal. there is no pleural effusion or pneumothorax. persistent atelectatic changes at the right lung base. the lungs are hyperinflated. there is no focal consolidation.
<unk>f with copd with sob x <num> days, evaluate for pneumonia..
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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. the lungs appear clear. bony structures are within normal limits.
shortness of breath.
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the lungs are clear. cardiac silhouette is normal in size. no pleural effusion, pneumothorax, pneumonia or pulmonary edema.
chest pain.
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there has been interval placement of a left-pectoral cardiac device with one lead terminating in the right ventricle. lung volumes are low and there is a small amount of right middle lobe atelectasis. otherwise, no significant interval change. stable prominence of the cardiomediastinal silhouette, which may be secondary to slight apical lordotic technique and low lung volumes. stable appearance of the hila and pleura. no focal consolidation, pleural effusion, pulmonary vascular congestion, or pneumothorax.
<unk>-year-old man presenting with cough and wheezing ; evaluate for pneumonia.
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pa and lateral views of the chest provided. midline sternotomy wires again noted. previously noted right ij central venous catheter is been removed. elevation of the left hemidiaphragm is unchanged with mild left basal atelectasis. a tiny nodular opacity at the right lung base could represent a small calcified granuloma. no convincing evidence for pneumonia or edema. there is mild central congestion. no large effusion or pneumothorax is seen.
<unk> year old man with new chest pain, wheezing
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pa and lateral chest radiographs demonstrate clear lungs. there is no pleural effusion, pneumothorax, or pulmonary vascular congestion. the cardiomediastinal silhouette is normal.
diabetic ketoacidosis. evaluation for infection.
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ap portable upright view of the chest. a metallic stent projects over the right axilla and subclavian region. cardiomegaly is re- demonstrated with diffuse pulmonary opacity concerning for severe pulmonary edema/ fluid overload. no large effusion or pneumothorax is seen. mediastinal contour appears grossly within normal limits. deformity at the medial aspect of the humeral heads could reflect prior posterior dislocation. please correlate clinically.
<unk>f with esrd ams // r/o pna
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there is no focal consolidation, no pleural effusion, vascular congestion or pneumothorax. the heart size is normal. the cardiac, hilar, and mediastinal contours are within normal limits.
recent pneumonia in <unk> that has resolved but symptoms have returned.
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the lungs are grossly clear without evidence of focal consolidation. there is no pleural effusion, pulmonary edema, or pneumothorax. the cardiomediastinal silhouette hilar contours are normal.
history: <unk>f with cp // eval for pneumo, infiltrate cm
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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. the lungs appear clear. a prominent anterior osteophyte is noted along the lower thoracic interspace, as before.
productive cough.
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the patient is status post sternotomy and aortic valve replacement. the heart is normal in size. there is mild unfolding of the thoracic aortic. there is no pleural effusion or pneumothorax. the lungs appear clear. bony structures appear within normal limits.
chest pain.
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the lungs are well inflated and clear. the cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. there is no pleural effusion or pneumothorax. visualized upper abdomen is unremarkable. there is an unchanged dextroscoliosis of the lower thoracic spine.
a flutter with rvr, evaluate for pneumonia.
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frontal and lateral views of the chest are compared to previous exam from <unk> and ct chest from <unk>. again seen is a right-sided pleural effusion which is not significantly changed in size, which is partially loculated posteriorly seen on the lateral view. opacity in the right mid lung is compatible post-irradiation changes, but better characterized by prior ct. the left lung remains clear. trace left-sided effusion is seen. the left lung remains clear. cardiomediastinal silhouette is unchanged. surgical clips in the right upper quadrant suggest prior cholecystectomy. osseous and soft tissue structures are unchanged noting multiple thoracic compression deformities, not definitely changed from ct scan.
<unk>-year-old female with chest pain. history of non-small cell lung cancer with recent chest ct with moderate effusion.
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the lungs are well inflated and clear. no pleural effusion or pneumothorax. heart size, mediastinal contour, and hila are unremarkable. a rounded opacity in the right lower hemi thorax is consistent with nipple shadow. limited assessment of the upper abdomen is within normal limits.
<unk>f with chest pain. assess for pneumothorax.
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marked elevation of the right hemidiaphragm is unchanged from the most recent prior study of <unk>. a right pectoral pacemaker is unchanged with two leads terminating in the right atrium and right ventricle. the right lung volume remains low; however, the lungs are clear without focal consolidation, pleural effusion or pneumothorax. the pulmonary vasculature is not engorged, and there is no overt pulmonary edema. the cardiac silhouette remains top normal in size but stable. the mediastinal contours are within normal limits with calcification of the aortic knob again seen. there is exaggerated kyphotic curvature of the thoracic spine with diffuse osteopenia.
history of aortic stenosis, now with shortness of breath, here to evaluate for congestive heart failure or pneumonia.
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left-sided pacemaker device is noted with single lead terminating in the region of the right ventricle. moderate to severe cardiomegaly is unchanged. the aorta remains tortuous. focal consolidative opacity is demonstrated within the right upper lung field concerning for pneumonia. additionally there is mild pulmonary vascular congestion. no pleural effusion or pneumothorax is identified though assessment of the right apex is obscured due to the patient's chin and neck soft tissues projecting over this region. no acute osseous abnormality is identified.
history: <unk>f with chest pain
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median sternotomy wires are intact. there is a left pacemaker with leads terminating in the right atrium and right ventricle. stable, mild cardiomegaly. normal mediastinal and hilar contours. focal opacification at the right base with silhouetting of the right heart border and right hemidiaphragm is concerning for small areas of pneumonia in the right middle and lower lobes. new, small right pleural effusion. left lung is clear. no pneumothorax.
<unk>-year-old man with right middle lobe pneumonia in <unk>, now with new cough and decreased breath sounds at the right base. evaluate for pneumonia.
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upright pa and lateral radiographs of the chest. there is an opacity at the left lower lung with meniscus on the lateral radiograph compatible with pleural effusion likely with a component of volume loss. underlying infection is a concern. the right lung is clear. the heart is not enlarged. the cardiomediastinal silhouette and hilar contours are normal. surgical clips project over the left axilla. the included upper abdomen is unremarkable.
chest pain. evaluate for pneumonia.
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cardiomediastinal contours are normal. the lungs are clear. there is no pneumothorax or pleural effusion. there are mild degenerative changes in the thoracic spine
history: <unk>f with <num> week of cough, productive green sputum // ?pneumonia
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compared to the prior study there is no significant interval change.
<unk> year old woman with seizures, respiratory failure, known b/l effusions. // please evaluate for interval change
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frontal and lateral chest radiographs demonstrate a right chest wall port with the tip terminating in the low svc/ cavoatrial junction. the cardiomediastinal silhouette is normal in the lungs are well aerated. a linear opacity in the left lower lobe is consistent with atelectasis or scarring. there is no focal consolidation, pleural effusion, or pneumothorax. the visualized upper abdomen is unremarkable.
evaluate for infiltrate in a patient with fever.
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the cardiac silhouette appears slightly smaller, as does the azygous vein. there is mild upper and perihilar venous distension, without other evidence of chf. there is subsegmental atelectasis in the right cardiophrenic region, unchanged. pigtail catheter again noted over the right chest, slightly different in configuration. no definite pneumothorax, though film contrast is noted to be relatively low.
<unk>m ptx // interval change
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lung volumes are slightly low. heart size is mildly enlarged, unchanged. the aorta remains tortuous. the mediastinal and hilar contours are similar. pulmonary vasculature is not engorged. minimal patchy opacities are noted in the lung bases. no pleural effusion, focal consolidation or pneumothorax is present. mild degenerative spurring is visualized in the thoracic spine.
history: <unk>m with palpitations and dyspnea
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pa and lateral views of the chest provided. dual lead pacemaker is unchanged. cardiomegaly is stable with no focal consolidation, large effusion or pneumothorax. mediastinal contour is stable. imaged bony structures appear intact appearing
<unk>m with dyspnea // infiltrate?
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the patient is status post median sternotomy, cabg, and left-sided pacer placement with leads terminating in the region of the right atrium and right ventricle. dense mitral annular calcifications are again noted. mild enlargement of the cardiac silhouette is unchanged. diffuse atherosclerotic calcifications of the thoracic aorta are noted. the mediastinal and hilar contours are grossly unchanged. no pulmonary edema is demonstrated. there is no focal consolidation, pleural effusion or pneumothorax. mild multilevel degenerative changes are noted throughout the thoracic spine. rounded calcifications in the left upper quadrant of the abdomen correspond to known aneurysms of the splenic artery.
history: <unk>f with vomiting, diarrhea
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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 fever // pna?
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there is a new left-sided effusion and new retrocardiac opacity. while some of the retrocardiac opacity could be due to effusion a could also be due to volume loss/infiltrate.
<unk> year old man with mental status change yesterday // please assess for pna or infection
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pa and lateral views of the chest demonstrate the lungs are well expanded and clear. a prominent left epicardial fat pad is noted. the heart size is normal, and the pleural and hilar contours are unremarkable. there is no pulmonary edema or focal consolidation concerning for pneumonia. mild multilevel degenerative changes are present in the thoracic spine.
dyspnea and palpitations.
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mild cardiomegaly is re- demonstrated. the mediastinal contour is similar. there is mild pulmonary vascular congestion, slightly worse in the interval. no pleural effusion or pneumothorax is present. no focal consolidation is identified. cervical spinal fusion hardware is incompletely imaged.
history: <unk>m with congestive heart failure with shortness of breath
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pa and lateral views of the chest provided. low lung volumes limit assessment. allowing for this, 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 cp r/o cardiopulmonary change
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pa and lateral views of the chest provided. there is no focal consolidation, effusion, or pneumothorax. there is mild atelectasis in the left upper lobe. right lower lobe atelectasis is minimal. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
history: <unk>f with asthma, pna history, p/w asthma sx x <num> month. // eval for pneumonia, other causes of respiratory wheeze
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low lung volumes with minimal subsegmental atelectasis in the lung bases. no interstitial edema. no pneumothorax. the cardiomediastinal silhouette is unremarkable. no significant pleural effusions.
<unk> year old man with new onset hypotension // ptx? pna?
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a right power injectable port-a-cath is present with the tip extending to the right atrium. innumerable bilateral pulmonary opacities are present consistent with metastases. interval decrease of the right pleural effusion, now small to moderate in extent. no pneumothorax identified. the size the cardiomediastinal silhouette is within normal limits.
<unk> year old woman with met endometrial cancer, s/p rt thorax // ptx? residual fluid?
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there is probable mild hyperinflation, suggesting background copd. the heart is not enlarged. there is patchy opacity in the right infrahilar/cardiophrenic region which may lie within the right middle lobe. minimal atelectasis noted at the left base. no other infiltrate is identified. no frank consolidation. no chf or effusion. slight asymmetric pleural thickening noted at the right lung apex .
cough and shortness of breath rule out pneumonia.
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portable view of the chest shows interval removal of an endotracheal tube. lung volumes are low and bibasilar atelectasis is unchanged as is the degree of pulmonary edema. there is no pneumothorax or definite pleural effusions. cardiomediastinal contour is stable. monitoring and support devices are unchanged in position.
<unk> year old man with dropping hematocrit.
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a single ap radiograph of the chest was acquired. the lungs are clear. the cardiac and mediastinal contours are normal. there are no pleural effusions. no pneumothorax is seen. there is no free air under the diaphragm. rounded opacities projecting over the anterolateral aspects of the right third and fourth rib correspond to old rib fractures, as seen on ct from <unk>.
gastroparesis. evaluate for free air.