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since the prior radiograph, there has been interval placement of an ng tube, which terminates in the stomach. endotracheal tube terminates <num> cm above the carina. the left pectoral pacemaker is unchanged in position, with leads terminating in the right atrium and right ventricle. one of the median sternotomy wires adjacent to the left sixth rib is broken, which was present since at least <unk>. lung volumes are low. there is bibasilar atelectasis, worse on the left. of note, a portion of the left inferolateral hemithorax is not captured on this study, but there is likely a pleural effusion on the left. no pneumothorax. mild to moderate cardiomegaly is stable in appearance. atherosclerotic calcifications are noted in the aortic arch.
<unk> year old man with s/p ngt placement // s/p ngt placement
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the lungs are well-expanded. the heart is top-normal in size. there is no pneumothorax or large pleural effusion. prominence of the pulmonary vascular markings, with mild peribronchial cuffing is noted. no focal consolidation worrisome for pneumonia is present.
<unk>f with dyspnea // eval for pulm edema, pna
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the cardiac, mediastinal and hilar contours are normal. lungs are clear and the pulmonary vasculature is normal. no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.
anterior chest pain.
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pa and lateral chest radiographs. there is no focal consolidation, pleural effusion, or pneumothorax. the cardiomediastinal silhouette is stable. transpedicular screws and fusion rods in the lower lumbar spine are partially visualized.
cough and fever.
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the endotracheal tube is in good position. the nasogastric tube terminates within the stomach and is curling back pointing towards the gastroesophageal junction. the left-sided port-a-cath is in good position. the left picc now within the brachiocephalic vein, and no longer within the azygos vein. left pneumonectomy expected postoperative changes are stable. persistent consolidation in the right lower lobe slightly worse. no right-sided pleural effusion or pneumothorax.
<unk> year old woman with lung adenocarcinoma and respiratory status post re placement of et tube // location of et tube?
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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>m with sob // sob
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heart size and cardiomediastinal contours are normal. lungs are clear without focal consolidation, pleural effusion, or pneumothorax. multilevel thoracic spine degenerative changes are mild and similar to prior.
<unk>f with chest tightness beginning today // eval for cardiopulm
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frontal and lateral views of the chest were obtained. the heart is of top normal size, likely exaggerated by technique. pulmonary vasculature is unremarkable. the lungs are clear without focal or diffuse abnormality. no pleural effusion or pneumothorax. the osseous structures are unremarkable. no radiopaque foreign bodies.
<unk>-year-old female with atypical chest pain. rule out infiltrate.
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there is a new focal opacity in the right upper lobe. there is likely atelectasis at the left lung base. the cardiomediastinal silhouette and hilar contours are stable. there is no pleural effusion or pneumothorax.
<unk>m with sob and low oxygen sat with fevers, evaluate for pneumonia
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no significant interval change. slight increased opacity in the right lower lobe is nonspecific and probably atelectasis, less likely aspiration, and similar in appearance to <unk>. no pleural effusion or pneumothorax. the heart is top-normal in size, overall unchanged. the descending thoracic aorta appears slightly tortuous or ectatic. the hila and pleura are stable in appearance. stable flattening of the diaphragms suggests hyperinflation. the incompletely visualized spinal hardware in the lower thoracic and upper lumbar spine appears intact and it is grossly unchanged in position from <unk>.
<unk>-year-old woman with history of cardiovascular accident who presents with a cough; evaluate for pneumonia.
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there is scarring in the right lower lobe. there is cardiomegaly and evidence of mitral valve replacement. otherwise, the hilar and cardiomediastinal contours are normal. there is no pneumothorax. there is no pleural effusion. pulmonary vascularity is normal.
<unk>-year-old woman with weakness and dizziness. evaluate for pneumonia.
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a portable frontal chest radiograph again demonstrates a left chest pacer device with leads projecting over the right atrium and ventricle. lung volumes are low, with bibasilar atelectasis and bronchovascular crowding. the cardiac silhouette is not well evaluated secondary to overlying opacity. there is mild pulmonary edema. retrocardiac opacity may be due to a combination of atelectasis and edema, but superimposed pneumonia cannot be excluded. there may be a small left pleural effusion. no pneumothorax is identified. the visualized upper abdomen is unremarkable.
shortness of breath.
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pa and lateral views of the chest provided. cardiomegaly is again noted. the mediastinal contour appears normal. there are bilateral pleural effusions, moderate on the right and small on the left. there is rib compressive atelectasis in the right lower lung. difficult to exclude an underlying pneumonia. no signs of edema or congestion. no pneumothorax. bony structures are intact.
<unk>m with pmh wegener's presenting c/o gradual onset chest pressure since yesterday // acute cardiopulmonary process
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since prior, there has been no significant interval change. the heart remains mildly enlarged. there are emphysematous changes without focal lung consolidation to suggest pneumonia. there is no evidence of pulmonary edema, pleural effusion, or pneumothorax.
<unk> year old woman with recent hip fx likely fat emboli complicated by hypoxia and cva, now on enoxaparin and with new hypoxia, evaluate for interval change.
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the lungs are well expanded and clear. there is no focal consolidation. the heart is top normal in size. there is no pneumothorax. the left costophrenic angle is not well visualized, which may reflect a trace pleural effusion.
<unk>-year-old female with weakness.
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there is a right port-a-cath with its lead terminating at the cavoatrial junction.
<unk>-year-old female with copd and asthma and lung cancer who presents with cough. evaluate for infection.
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shallow inspiration accentuates heart size, pulmonary vascularity. stable bilateral perihilar opacities, likely edema. mildly worsened right apical opacity, edema likely, consider pneumonitis. stable left pleural effusion, with left basilar consolidation.
<unk> year old woman with essential thrombocythemia/myelofibrosis, cirrhosis and renal failure (hd in the past), prior pe, mild copd who presented to ed from liver clinic w/lle pain and swelling, found to have sbp. now called out from the micu s/p flash pulmonary edema. now with new sob and o<num> requirement. // please evaluate for fluid overload vs. consolidation given new o<num> requirement.
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stable minimal interstitial edema. small right pleural effusion with redemonstration of fluid tracking along the right major and minor fissures. no concerning focal opacification evident. no pneumothorax. no compression deformities are evident. no displaced rib fracture detected.
status post mechanical fall with rib pain and fracture.
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chest pa and lateral radiograph demonstrates a left upper lobe opacification with area of central lucency concerning causing abrupt termination of a left upper lobe bronchus. finding is nonspecific with etiologies ranging from possibly malignancy such as squamous cell carcinoma or acute infectious process, such as abscess, active tuberculosis, necrotizing pneumonia, or fungal infection. cardio mediastinal and hilar contours are unremarkable. no pleural effusion or pneumothorax is evident. no osseous abnormalities are identified.
cough, fever, reduced breath sounds at the left base. please evaluate for pneumonia.
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lungs are clear. cardiomediastinal silhouette is unremarkable. no pneumothorax. slight blunting of the left costophrenic angle.
<unk> year old man with l mca stroke // eval for pneumonia
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small left pleural thickening/effusion and retrocardiac opacity. mild volume loss with mediastinal shift to the left and left paramediastinal linear opacities likely reflect post treatment changes. the right lung is clear. no pulmonary edema. mild cardiac enlargement. no pneumothorax. bilateral mastectomies.
<unk> year old woman with left lower lobe decreased bs // consolidation?
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the heart size remains mildly enlarged. mediastinal and hilar contours are stable. there is no pulmonary vascular congestion. minimal atelectasis is noted within the right middle lobe. smooth bilateral pleural thickening is seen laterally, unchanged, likely reflecting subpleural fat deposition. no pleural effusion or pneumothorax is clearly identified. there are mild degenerative changes within the thoracic spine. no displaced rib fractures are noted.
right-sided rib pain after falling.
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the heart continues be mildly enlarged. the mediastinal and hilar contours are stable, and there is scattered calcifications at the aortic knob. there is unchanged cephalization of the vasculature. no focal consolidation, pleural effusion or overt pulmonary edema is seen.
<unk>-year-old female with shortness of breath. evaluate for pneumonia.
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frontal and lateral views of the chest were performed. no pneumothorax. no pleural effusion or focal airspace consolidation. normal cardiac, mediastinal and hilar contours. normal upper abdomen. no acute osseous abnormality.
left chest pain which is pleuritic in nature. evaluate for a pneumothorax.
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lung volumes are low. the heart size remains mildly enlarged, and likely accentuated due to low lung volumes. mitral annular calcifications are noted. mediastinal and hilar contours are unremarkable. mild no frank pulmonary edema is seen, there is crowding of the bronchovascular structures with probable mild pulmonary vascular congestion. streaky bibasilar airspace opacities could reflect atelectasis or chronic changes. no pleural effusion or pneumothorax is identified. hardware seen within the right proximal humerus.
confusion.
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pa and lateral views of the chest. there is no focal consolidation. cardiomediastinal silhouette is normal. there is no pleural effusion or pneumothorax.
<unk>-year-old female with left lower rib pain, evaluate for infiltrate.
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right internal jugular venous catheter terminates in lower svc. et tube terminates <num> cm above the carina. a transesophageal terminates in the stomach. right lung base aeration is slightly improved compared to <num> day ago. there are persistent bibasilar atelectasis and moderate pleural effusions. cardiomediastinal silhouette is stable. mild pulmonary edema is stable. right bronchial stents are noted. narrowed trachea at the thoracic inlet is likely configurational.
<unk> year old man with rll bronchial lesion // please assess for ett position, progression of r sided collapse. patient is post right middle lobe and lower lobe bronchial stents.
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ap upright and lateral views of the chest provided.there is no focal consolidation, effusion, or pneumothorax. curvilinear calcification projecting over the heart likely reflects mitral annular disease. coronary stents are seen projecting over the heart. the cardiomediastinal silhouette is stable with top-normal heart size. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
<unk>f with cp // eval pneumonia vs chf
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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 <num> episode of seizure today
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the patient is status post median sternotomy with at least one broken sternal wire. a group of rounded densities, ~ <num>mm or less in diameter, are seen in the right upper lobe, likely granulomas. there is slight thickening of the minor fissure on the right. possible mild atelectasis immediately above the minor fisure. mild basilar atectasis. cardiac silhouette is top normal in size. the aorta is tortuous. no air-fluid level is appreciated. there is no pneumoperitoneum or pneumomediastinum. degenerative changes of the thoracic spine are noted.
concern for food impaction.
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frontal and lateral chest radiographs were obtained. no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. the heart size is normal. mediastinal contours are normal. there is mild diffuse demineralization.
persistent cough, evaluate for pathology.
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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.
history: <unk>m with cough // eval heart and lungs
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as compared to <unk>, mild pulmonary vascular congestion with small bilateral pleural effusions. bibasal opacities are atelectasis. mild cardiomegaly and tortuosity of the aorta with heavy calcifications. no pneumothorax.
<unk> year old woman pod <unk> s/p robot-assisted pancreatectomy and splenectomy now with increased o<num> demand // please evaluate for possible pulmonary edema/effusion, atelectasis
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left-sided pacemaker and wires are appropriate position. moderate cardiomegaly is stable. there is a mild increase in interstitial markings which may represent mild pulmonary edema. there is a small left effusion. no definite focal consolidations. no pneumothorax.
history: <unk>f with ams // pna?
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lung volumes remain low. the right picc tip terminates at the cavoatrial junction. heart size remains mildly enlarged, and is accentuated by the low lung volumes. mediastinal contours are unchanged. there is crowding of the bronchovascular structures as a result of low lung volumes with probable mild pulmonary vascular engorgement. bibasilar opacities appear progressed compared to the prior exam, and may reflect worsening atelectasis though infection is not excluded. small left pleural effusion persists. no pneumothorax is identified.
shortness of breath
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heart size is borderline enlarged. the mediastinal and hilar contours are unremarkable. pulmonary vasculature is normal. apart from mild left basilar atelectasis, the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is detected. no subdiaphragmatic free air is present. no acute osseous abnormality is seen.
history: <unk>f with fever, left upper quadrant pain
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there is no focal consolidation, pleural effusion or pneumothorax. the cardiomediastinal silhouette is normal. the imaged upper abdomen is unremarkable. the bones are intact.
history: <unk>f with pain over her entire body // r/o pna
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the heart is at the upper limits of normal size. the mediastinal and hilar contours appear unchanged. the lung volumes are low. patchy medial basilar opacity suggests minor atelectasis. otherwise, the lungs appear clear. there is no pleural effusion or pneumothorax. there is no evidence for mediastinal widening or pneumomediastinum.
vomiting. question <unk> tear.
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there is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. the osseous structures and upper abdomen are unremarkable.
<unk>m with altered mental status, evaluate for pneumonia.
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there is elevation of the left hemidiaphragm with mild left basilar atelectasis. the lungs are otherwise clear without focal consolidation, pleural effusion or pneumothorax. the pulmonary vasculature is not engorged. the cardiac silhouette is incompletely evaluated due to silhouetting of the left heart border. there is tortuosity of the thoracic aorta. no acute osseous abnormality is detected.
history: <unk>m with doe <num> month. ekg with ste // acute process
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the right-sided pigtail catheter is unchanged in position. a left-sided biventricular pacer partially obscures the left mid lung. the loculated right pleural effusion has increased, and is now moderate in size. a rounded airspace opacity in the right upper lung zone likely reflects fluid in the major fissure. cardiomegaly is unchanged. lingular linear atelectasis is again noted. new blunting of the left costophrenic angle may be due to a small pleural effusion.
<unk> year old woman with chf s/p biv pacer, hx ovarian cancer, recurrent r pleural effusion now s/p chest tube // please assess interval change in r pleural effusion
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blunting at the left costophrenic angle appears unchanged from <unk> and may represent pleural parenchymal scarring. the lungs are otherwise clear without focal consolidation, pleural effusion or pneumothorax. the pulmonary vasculature is not engorged. there is no overt pulmonary edema. the cardiomediastinal and hilar contours are within normal limits. there is no acute osseous abnormality detected.
dyspnea and wheezing, here to evaluate for pneumonia.
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pa and lateral views of the chest provided. the lungs are hyperinflated with upper lobe lucency and splaying of bronchovascular markings suggestive of emphysema. no focal consolidation, large effusion or pneumothorax. cardiomediastinal silhouette is stable. bony structures are intact peer
<unk>f with dyspnea, cough x<num> days // eval for pna or acute process
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the tip of the enteric to terminates in the gastric fundus, but the sidehole is seen at the level of the gastroesophageal junction. a right-sided port-a-cath terminates at the cavoatrial junction. there is no evidence of pneumonia, pleural effusion or pneumothorax. known pulmonary metastases are better evaluated on the recent chest ct dated <unk>. cardiomediastinal silhouette is within normal limits.
history: <unk>f with ng tube // ? positioning of ng tube
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the cardiac, mediastinal and hilar contours appear stable. the left lung is clear. right hemithorax shows extensive subpleural thickening and opacification particularly at the right lung apex without change. there is no definite pleural effusion or pneumothorax. chest is hyperinflated. calcified pleural plaques are present.
shortness of breath.
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minimal interval decrease in size of the opacity in the superior segment of the left lower lobe. unchanged left pleural effusion. the right lung is clear. the size and appearance of the cardiomediastinal silhouette is unchanged.
<unk> year old woman with left opacity // enlargement of left opacity
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one portable semi-erect ap view of the chest. the right lung is clear. there is mild left basal atelectasis. no pleural effusions or pneumothorax. no focal parenchymal opacities concerning for pneumonia. the cardiac, mediastinal, and hilar contours are normal. no evidence of volume overload.
subdural hematoma, extubation, new desaturations.
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the endotracheal tube and enteric tube remain in standard positions. there is persistent opacification of the left hemithorax with leftward shift of the mediastinal structures. there is minimal improved aeration within the left lung base, but continued marked atelectasis of the left lung with at least a small left pleural effusion. fiducial marker indicating the site of an endobronchial lesion in the left mainstem bronchus is re- demonstrated. right lung remains clear. no pneumothorax is identified.
history: <unk>f with hypoxia // eval for ptx, worsening effusion
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ap upright and lateral chest radiograph demonstrate no focal opacity convincing for pneumonia. heart is within normal limits in size. mediastinal and hilar contours are unremarkable. there is no pleural effusion or pneumothorax. visualized osseous structures demonstrate no acute abnormality.
<unk>-year-old female with chest pain.
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the patient is rotated towards the left and the chin obscures the upper lung apices, bilaterally. additionally, lung volumes are low leading to crowding of the bronchovascular structures. within these limitations, there is mild cardiomegaly and central pulmonary vascular congestion. left retrocardiac streaky opacity likely reflects atelectasis. there is no lobar consolidation, pleural effusion, or pneumothorax.
history: <unk>m with cough, hypotension // eval for pna
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eventration of the right hemidiaphragm is noted anteriorly with adjacent right lung base atelectasis. the lungs are clear of focal consolidation, pleural effusions or overt pulmonary edema. the heart and mediastinal contours are within normal limits.
<unk> year old female with chest pain.
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lungs are fully expanded and clear. there is no focal consolidation, effusion, or pneumothorax. mediastinal and hilar contours are normal. heart size normal.
history of pulmonary embolism, pre vq scan.
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the cardiac silhouette size appears mildly enlarged but similar compared to the prior study. mediastinal and hilar contours are unchanged. mild to moderate pulmonary edema and small right pleural effusion are identified, new in the interval. patchy atelectasis is also seen in the lung bases. no pneumothorax is present. there are no acute osseous abnormalities.
history: <unk>f with recent nstemi, presents with fatigue, chest pain, elevated bnp
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there is slight coarsening of the central airways, which may reflect an inflammatory process, but no focal consolidation is present. there is no pleural effusion or pneumothorax. the heart is normal in size. mild-to-moderate degenerative changes along the mid-to-lower thoracic spine, including a slight wedging of a mid-to-lower thoracic vertebral body are similar.
rhonchi, cough and malaise. question infiltrate.
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there is a large right pleural effusion which appears to be partially loculated, with residual aeration of right upper lobe. there is a drain in place in the right lung base. the left lung is clear aside from mild atelectasis at the lung base. there is no pneumothorax. cardiomediastinal silhouette is partially obscured by the right pleural effusion, but is unremarkable. orthopedic fixation hardware seen in the right humeral head.
fever, concerning for pneumonia, reported h/o lung cancer.
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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 cough and chest pain // acute process, pna?
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lung volumes are low leading to crowding of the bronchovascular structures. bibasilar airspace opacities, right greater than left, likely reflecting patchy atelectasis. there is no pleural effusion, pneumothorax, or pulmonary edema. the cardiomediastinal silhouette is within normal limits.
history: <unk>m with weakness, confusion // eval for infiltrate
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no significant change from <time>. an enteric tube terminates within the distal esophagus and should be advanced at least <unk>-<num> cm for appropriate positioning. low lung volumes again noted. pulmonary masses in pulmonary nodules better seen on prior clear exams. distention of the colon is also noted.
<unk>m with s/p ng tube // eval for ng tube
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there is a left chest cardiac device with associated dual leads projecting over the right atrium and right ventricle in unchanged, generally appropriate configuration. there is a stable cardiomediastinal contour consistent with a mildly tortuous thoracic aorta and mild cardiomegaly. an opacity in the medial right lower lobe is unchanged in comparison to multiple prior chest x-rays dating back to at least <unk>. there is no new focal lung consolidation. there is no pulmonary venous congestion or pulmonary edema. there is no pneumothorax or pleural effusion. moderate thoracic spine degenerative change is noted on lateral view.
<unk>-year-old woman with diabetes, congestive heart failure presenting with elevated glucose, evaluate for infectious process, effusion.
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cardiac silhouette size is normal. mediastinal and hilar contours are unchanged. no overt pulmonary edema is present. there is persistent small right pleural effusion with associated right basilar atelectasis. left lung is clear. no pneumothorax is present. no acute osseous abnormalities demonstrated.
history: <unk>m with hep c cirrhosis, <num> weeks of dyspnea on exertion, history of pleural effusion
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lung volumes are low. heart size is top normal. mediastinal and hilar contours are unremarkable. pulmonary vasculature is normal. no focal consolidation, pleural effusion or pneumothorax is present. there are no acute osseous abnormalities.
history: <unk>f with <num> hr of chest pain radiating to right shoulder, worse with inspiration
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the trauma board overlies the patient and somewhat obscures the film. with this in mind, the lungs are clear. the cardiac silhouette is normal in size. there is no pleural effusion and there is no pneumothorax.
<unk>-year-old male in a motor vehicle accident.
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there are low inspiratory volumes. the minor fissure is retracted, suggesting atelectasis in the right upper zone. minimal patchy opacity at both lung bases likely represents atelectasis, but an early aspiration pneumonia or other pneumonic infiltrate cannot be entirely excluded. no frank consolidation or air bronchograms identified. no gross effusion. apparent vascular plethora is likely an artifact of low inspiratory volumes. the cardiomediastinal silhouette is also prominent, but likely accentuated by low lung volumes.
<unk> year old man with seizure and agitation // eval for pulmonary process
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the lungs are not completely expanded. there is mild plate like atelectasis at the right lung base. no focal consolidation, pulmonary edema, pleural effusion, or pneumothorax. the cardiomediastinal silhouette is unremarkable. the descending aorta is ectatic or tortuous. no acute osseous abnormality.
<unk>-year-old man presenting with shortness of breath; evaluate for pneumonia.
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the right lung is clear. post-surgical changes in the left lower hemithorax are essentially unchanged from the prior exam. probable small left pleural effusion with adjacent atelectasis. no pneumothorax, pulmonary edema, or focal consolidation to suggest pneumonia. stable cardiomediastinal silhouette, hila, and pleura. incidental fifth left lateral rib fracture, present on the prior exam, age indeterminate.
<unk>-year-old woman with a spiculated left lower lobe superior segment mass, found to the adeno carcinoma with metastases, status-post recent left lower lobectomy; evaluate for interval change.
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low lung volumes are again noted. there is been interval improvement of the previously noted pulmonary edema which is now mild. there is no new consolidation. cardiomediastinal silhouette is stable. there is no large effusion.
<unk>m with resp distress // ? infiltrate
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there has been interval placement of an endogastric tube whose side port is well below the ge junction. otherwise, the heart size is at the upper limits of normal. the lung volumes are low with stable mild edema and retrocardiac atelectasis. there is no pneumothorax. small bilateral pleural effusions.
<unk>-year-old male with recent placement of a nasogastric tube.
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bibasilar platelike subsegmental atelectasis is seen. there is slight blunting of the left costophrenic angle which may be due to atelectasis but trace pleural effusion is not excluded. no definite focal consolidation is seen. the lungs are relatively hyperinflated, suggesting chronic obstructive pulmonary disease. no pneumothorax is seen. the cardiac and mediastinal silhouettes are stable.
history: <unk>f with fever, immunosuppressed // eval for pna
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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 unremarkable.
intermittent chest pain and cough.
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frontal and lateral chest radiographdemonstrates well expanded lungs with minimal linear atelectasis in the left lower lung. no focal opacity.no pleural effusion or pneumothorax. heart size, mediastinal contour, and hila are unremarkable.limited assessment of the osseous structures is grossly unremarkable without displaced rib fracture.
motor vehicle collision. left-sided chest pain. assess for rib fracture.
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there is a small right pleural effusion with overlying atelectasis. right base opacity may be due to combination of pleural effusion and atelectasis, but consolidation due to pneumonia is not excluded. no pneumothorax is seen. the cardiac silhouette is enlarged. mediastinal contours are stable. the aorta is calcified. no pulmonary edema is seen.
history: <unk>m with unsteady gait, eval for infectious etiology // pneumonia
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there are moderate bilateral pleural effusions with volume loss/infiltrate in both lower lungs. there is mild pulmonary vascular redistribution. the heart size is mildly enlarged. the aorta is calcified and tortuous. spine demonstrates a mild scoliosis and degenerative changes.
right mca stroke and copd.
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the new et tube ends <num> cm from the carina. the right ij central venous catheter is in unchanged position with the tip in the low svc. the enteric tube tip passes below the diaphragm, however the side port is within a moderate hiatal hernia. this should be advanced <num> cm for optimal positioning. allowing for changes in positioning, there is no focal consolidation, pneumothorax, or pulmonary edema. there may be a small left pleural effusion. there is stable mild cardiomegaly. note is made of total right shoulder arthroplasty and anterior and posterior cervical fusion devices. there are moderate degenerative changes of the left glenohumeral joint.
<unk> year old woman with ett // eval tube
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there is a right port-a-cath with its tip terminating in the proximal right atrium. the heart size is normal. the lungs are hyperinflated, likely reflective of copd. a small left pleural effusion is again noted. there is a peripheral opacity in the right middle lobe, only seen on the lateral radiograph. prominence of the pulmonary arteries is likely reflective of pulmonary arterial hypertension. prior left rib fractures are noted.
<unk>-year-old male with chest pain. please evaluate.
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portable frontal chest radiograph demonstrates low lung volumes exaggerating moderate cardiomegaly. there is mild pulmonary vascular congestion. no focal consolidation, pleural effusion, or pneumothorax is appreciated. of note, the left costophrenic angle is not included on the image.
history: <unk>m with bradycardia // eval for acute process
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dual lead left-sided pacer device is stable in position. right perihilar opacity, seen to project over the superior segment of the right lower lobe on the lateral view, most consistent with pneumonia. the left lung is clear. no pleural effusion or pneumothorax is seen. cardiac and mediastinal silhouettes are unremarkable.
history: <unk>m with fever and cough // eval pneumonia
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in comparison with the study of <unk> there is mild improvement in the central pulmonary vascular congestion as well as the bibasal opacities. moderate bilateral pleural effusions persist. no pneumothorax. left-sided internal jugular catheter has been removed. a new right-sided picc with the tip in the lower svc. no pneumothorax.
<unk> year old man with copd, boop on chronic steroids, severe tracheobronchomalacia s/p tracheobronchoplasty, afib (not on coumadin), cad (s/p mi and cabg), schf (<unk>%) being treated for mrsa/pseudomonas pna now sob. // new pulmonary edema?
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a left ij catheter tip projects over the expected region of the mid to low svc. the patient is status post median sternotomy and the wires appear intact. opacity in the right upper lung could reflect focal pneumonia in the appropriate clinical situation. opacities in the right perihilar and infrahilar region may reflect atelectasis. opacity of the left retrocardiac region and loss of definition of the left medial hemidiaphragm may be secondary to consolidation as seen with infection and/or atelectasis, although a mass cannot be excluded. the heart is probably top-normal in size even on this ap view. the patient is presumed semi upright, however there appears to be layering small bilateral pleural effusions in the lung apices. aortic knob calcifications are mild. no acute osseous abnormality. small amount of fluid tracks in the minor fissure.
<unk>-year-old woman presenting with shortness of breath. evaluate for pneumonia.
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the cardiac silhouette is top-normal. mediastinal contours are unremarkable. overlying soft tissue slightly limits evaluation of the lung bases, although no definite focal consolidation is seen. no large pleural effusion or pneumothorax. no overt pulmonary edema.
history: <unk>f with rapid a flutter // eval cardiomegaly, infiltrate
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frontal and lateral views of the chest demonstrate a ph capsule in the mid to lower esophagus. the cardiomediastinal silhouette is normal. the lungs are clear, without pneumothorax, vascular congestion, or pleural effusion. cholecystectomy clips are noted.
<unk>-year-old female with vomiting status post capsule study. question free air.
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cardiac silhouette is mildly enlarged with tortuosity of the thoracic aorta. hilar contours are unremarkable. lungs are clear. there is no large effusion or pneumothorax. diffuse bony sclerosis is compatible with metastatic disease.
weakness and ekg changes with suspicion for chf.
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a single portable frontal chest radiograph was obtained. lung volumes remain low. the lungs are clear without new consolidation, effusion, or pneumothorax. bibasilar atelectasis is minimal. sternotomy wires intact. pacing leads remain in appropriate locations. enteric catheter projects over the stomach.
<unk>-year-old man status post cabg.
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since <unk>, the opacity in the medial right upper hemithorax has improved, most consistent with improving right middle lobe collapse. otherwise, no significant interval change. stable elevation of the right hemidiaphragm status post right upper lobectomy. stable cardiomediastinal silhouette. the left lung is clear. no pneumothorax, focal consolidation to suggest pneumonia, pulmonary edema, or pleural effusion. the bilateral calcified pleural plaques are unchanged.
<unk> year old man with enlarging rul nodule now s/p rul wedge with completion lobectomy on <unk>; evaluate for interval change.
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heart size is normal. the aortic knob is calcified. the mediastinal and hilar contours are unremarkable. numerous mediastinal clips are present. pulmonary vascularity is normal and the lungs are clear. no pleural effusion or pneumothorax is seen. there are multilevel degenerative changes in the thoracic spine.
hypotension.
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as similar to multiple prior exams, there is a relative hazy density in the bilateral hilar regions with pulmonary vascular indistinctness. the hemidiaphragms are not well defined. the cardiomediastinal silhouette is markedly enlarged with widening superiorly and an enlarged cardiac silhouette inferiorly. the patient's chin overlies the lung apices, limiting the evaluation. no gross pneumothorax is seen.
shortness of breath and hypoxia.
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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. no displaced fracture is seen.
left-sided chest pain and elevated st on ekg.
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there is biapical scarring. linear bibasilar opacities are most compatible with atelectasis. the lungs are otherwise clear. right-sided central venous catheter is no longer visualized. the cardiomediastinal silhouette is within normal limits. surgical clips project over the mid upper abdomen.
<unk>m with sob, cough // eval for consolidation
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portable semi upright chest radiograph. recently placed a dobbhoff feeding tube is curled within the esophagus with tip directed superiorly located the level of the clavicular heads. right internal jugular central venous catheter is unchanged in position. dense left basal consolidation and milder right opacities are slightly increased from the previous examination along with unchanged left mild-to-moderate pleural effusion. there is no pneumothorax. heart and mediastinal contours are unchanged. previously administered contrast again noted in the stomach. descending aortic vascular calcifications are moderate in severity.
status post laparoscopic hiatal hernia repair and resolving cholangitis. status post dobbhoff tube placement.
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the enteric tube tip ends within the stomach, however the side port is not definitively visualized, likely overlying the spine. this should be advanced <num>-<num> cm for optimal placement of all ports within stomach. there is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. the cardiomediastinal silhouette is within normal limits.
<unk>f with sbo status post ngt placement, evaluate placement of nasogastric tube.
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there is no marked change in the positioning of the chest wall port which terminates at the confluence of the brachiocephalic veins. the study is otherwise unchanged with moderate bilateral pleural effusions as well as obscuration of the diaphragmatic contours due to atelectasis or airspace consolidation. there is no pneumothorax.
evaluate positioning of chest port, which is no longer working.
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the lungs are well-expanded and clear. no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. the cardiomediastinal silhouette, hila, and pleura are normal.
<unk>-year-old woman, total right hip replacement.
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cardiomediastinal contours including enlargement of the cardiac silhouette is stable. sternotomy hardware and pacemaker leads are unchanged in position. mild pulmonary interstitial edema is no worse compared to multiple prior studies. there is no evidence of new consolidation or large pleural effusion. no pneumothorax.
<unk>f with shortness of breath // eval for chf or pna
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normal cardiomediastinal and hilar contours. fully expanded, clear lungs. no evidence of pneumonia or pneumothorax. slight thickening of the right major fissure. no definite soft tissue or osseous abnormalities.
<unk>-year-old woman with clinical concern for pneumonia.
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cardiac silhouette size is normal. the patient is status post right upper lobectomy. mediastinal and hilar contours are unchanged with prominence of the left hilum reflective of underlying lymphadenopathy, better assessed on the recent ct. lungs are hyperinflated without focal consolidation. known nodules within the left upper lobe and left lower lobe are better appreciated on the previous ct. no pleural effusion or pneumothorax is present. there are no acute osseous abnormalities.
history: <unk>f with fever, altered mental status
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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.
<unk> year old woman with severe asthma, current flare, some diminished breath sounds on the left. // r/o pna
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the patient is status post pleural biopsy and talc pleurodesis. there is increased pleural fluid on the right, which appears to layer along the chest wall. the right paramediastinal and parahilar soft tissue densities appear similar. the left lung is similar appearance to the prior exam. lung volumes have decreased.
<unk> year old man with recurrent pleural effusion s/p vats presenting with epistaxis and ? hemoptysis // evaluate for recurrent effusion
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the lungs are well-expanded and clear. there is no pneumothorax, pleural effusion, pulmonary edema, or focal airspace consolidation. the cardiomediastinal silhouette is unremarkable. scoliotic curvature of the thoracic spine is noted.
history: <unk>f with chest pain // eval for ptx or pna
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heart size is normal. mediastinal and hilar contours are unremarkable. pulmonary vasculature is not engorged. linear opacity in the right mid lung field is compatible with subsegmental atelectasis. no focal consolidation, pleural effusion or pneumothorax is identified. there are mild multilevel degenerative changes seen in the thoracic spine.
history: <unk>f with fever and cough
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pa and lateral views of the chest provided. fusion hardware is again seen in the cervicothoracic junction. lungs appear hyperinflated and clear. 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 syncope here in ed, reports chest pain and sob prior to syncopal episode. reports chronic cough
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the the cardiac silhouette normal. the pulmonary vasculature and mediastinal contours are unremarkable. there is no pleural effusion or pneumothorax. no focal consolidation is seen.
<unk> year old man with esrd type <num> diabetes, pre-dialysis, // evaluate lung status