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MIMIC-CXR-JPG/2.0.0/files/p16119588/s51039713/bac0dd8f-a3f65294-2932027d-1803206c-f13981e8.jpg
severe emphysema with mild bibasilar atelectasis and small bilateral pleural effusions, slightly increased in size on the right compared to prior. enlarged pulmonary arteries suggestive of underlying pulmonary arterial hypertension. no new focal consolidation.
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central venous line tip is in the right atrium and should be pulled back <num> cm. ng tube tip is in the proximal stomach and might be advanced giving the side hole being most likely located at the gastroesophageal junction or above. et tube tip is approximately <num> cm above the carinal. heart size and mediastinum ar...
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hyperinflation is much more severe today than on any prior examinations suggesting acute bronchospasm. lungs are free of any focal abnormality. cardiomediastinal and hilar silhouettes and pleural surfaces are normal. esophageal drainage catheter ends at the level of the diaphragm an would need to be advanced at least <...
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no evidence of pneumonia.
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consolidation of the posterior basal segment of the right lower lobe compatible with pneumonia with likely associated small pleural effusion. recommend follow-up to resolution.
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mild pulmonary edema.
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left-sided hernia, may be diaphragmatic or hiatal with air-fluid levels seen and with blunting of the left costophrenic angle which may be due to atelectasis with possible small pleural effusion.
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the right-sided chest tube, right-sided picc line, and feeding tube are unchanged in position. there is again seen volume loss and increased density in the right lung. the tiny right apical pneumothorax seen previously is no longer visualized. the left lung is well-aerated aside for atelectasis at the left base.
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endotracheal tube and nasogastric tube are unchanged in position. there is diffuse bilateral interstitial abnormality which has worsened and is consistent with worsening mild-to-moderate interstitial edema. the heart remains enlarged which may reflect cardiomegaly, although pericardial effusion should also be considere...
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no pneumothorax. normal chest radiograph.
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appropriate placement of nasogastric tube. no acute cardiopulmonary process.
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enlarged cardiac silhouette and pulmonary edema. mild-to-moderate pulmonary edema appears decreased as compared to the prior study. possible trace pleural effusions.
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as compared to the previous radiograph, the patient was extubated and the nasogastric tube was removed. the lung volumes are lower than on the previous image. unchanged atelectasis at the right lung bases. unchanged multiple posttraumatic rib deformities on the right. no evidence of overt pulmonary edema. no larger ple...
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no acute intrathoracic findings.
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in comparison with the study of , there is little interval change. again there is some hyperexpansion of the lungs without evidence of pneumothorax. little change in the blunting of the right costophrenic angle and patchy opacification at the left base.
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normal chest radiograph. a preliminary read was provided via telephone by dr to at the office of dr at on.
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in comparison with study of , the right ij catheter extends to the lower svc. intestinal tube extends at least to the second portion of the duodenum. no evidence of acute pneumonia, vascular congestion, or pleural effusion.
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worsening pulmonary edema with enlarged cardiac size which may also be due to pericardial effusion. follow up radiographs are recommended. worsening bilateral parenchymal opacities, worse on the right, may also be explained by concurrent pneumonia. these findings were discussed by dr , with dr , at ,.
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no significant interval change in bilateral predominantly perihilar ill-defined airspace opacities which may reflect a multifocal infectious process, but is nonspecific.
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no acute cardiopulmonary process.
MIMIC-CXR-JPG/2.0.0/files/p17983771/s57590454/2da7b635-c67dcf57-847bef02-fd091ea3-c950e72a.jpg
no acute cardiopulmonary process.
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no acute cardiac or pulmonary process.
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no focal opacity concerning for pneumonia is identified.
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cardiomegaly with mild congestion pulmonary edema.
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bibasilar regions of consolidation, which could be due to pneumonia in the proper clinical setting. component of atelectasis, particularly on the left is also possible.
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findings suggest mild interstitial edema.
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postsurgical changes in the right lung without evidence of acute cardiopulmonary abnormality. probable copd.
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no focal consolidation concerning for pneumonia. increased haziness at the lung bases bilaterally may indicate small airways infection or inflammation.
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comparison to. the patient is after lung biopsy. there is a <num> mm left apical pneumothorax without evidence of tension. the consolidation sign masslike lesions in the left lung are stable. minimal left pleural effusion. stable normal appearance of the right lung.
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pulmonary vascular congestion accompanied by interstitial edema and small pleural effusions. patchy bibasilar opacities most likely represent atelectasis, but aspiration and developing pneumonia are additional considerations.
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no acute cardiopulmonary process. findings were communicated by dr to dr by phone at on.
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lung volumes remain somewhat low. the perihilar vasculature is prominent and south lies consistent with underlying pulmonary venous hypertension that. on the main pulmonary artery is enlarged consistent with known underlying pulmonary hypertension. there is a reticular nodular interstitial abnormality which may be rela...
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persistent bilateral lower lobe atelectasis. no evidence of pneumonia or decompensated heart failure. mild enlargement of the thoracic aorta without focal aneurysmal dilation, could be further assessed with ct.
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no acute intrathoracic process.
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tubes positioned appropriately. mild left basal atelectasis, otherwise unremarkable.
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nasogastric tube has been advanced an the first side port is in the distal body of the stomach.
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as compared to radiograph, a nasogastric tube is been placed, with tip terminating just below the level of the thoracic inlet. subsequent radiograph performed and dictated separately documents successful repositioning or replacement of this catheter. exam is otherwise remarkable for low lung volumes, bibasilar opacit...
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tip of the enteric tube cannot be visualized on this exam. recommend repeat radiographs to confirm tip placement.
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no evidence of pneumonia or heart failure.
MIMIC-CXR-JPG/2.0.0/files/p11714071/s59991794/1eaf93f5-ae7986a3-77ef5099-ad9d86db-00a614b2.jpg
no acute cardiopulmonary process.
MIMIC-CXR-JPG/2.0.0/files/p15650925/s59238409/f90fe86d-ca3caee3-00f88ebc-31eb3c09-8975730d.jpg
no acute cardiopulmonary process.
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no acute cardiopulmonary process; specifically, no evidence of active tuberculosis.
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since the prior radiograph of <num> day earlier, the patient has apparently been extubated. apparent narrowing of the proximal trachea could potentially represent edema in the post intubation state but is suboptimally evaluated due to patient rotation and portable radiographic technique. cardiomediastinal contours are ...
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increasingly prominent interstitial structures and nodular opacities within notable absence of pleural effusions, which is not typical for an hydrostatic pulmonary edema. other possible etiologies including lymphangitis or fibrotic lung disease should be considered.
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enlarged cardiac silhouette with globular appearance, as also on the prior study, could be due to pericardial effusion or underlying cardiomyopathy. blunting of the bilateral costophrenic angles may be due to trace bilateral pleural effusions.
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no acute intrathoracic process.
MIMIC-CXR-JPG/2.0.0/files/p16942853/s52933933/aa678f37-2090bcc4-eac84811-637bb4f7-f96c6370.jpg
no acute cardiopulmonary process.
MIMIC-CXR-JPG/2.0.0/files/p19585869/s52813112/5d836f43-01e93718-5e537250-cce932a3-c11bbc14.jpg
possible slight worsening of retrocardiac opacity. chf findings are similar to the prior study. right subclavian central line tip overlies right atrium.
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no lobar consolidation to suggest bacterial pneumonia. as describe on prior report, subtle bibasilar opacities may represent viral/atypical infection; followup imaging is recommended after therapy to document resolution. apparent right glenohumeral joint subluxation. correlate for pain.
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chronic interstitial lung disease and possible fluid overload.
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compared to chest radiographs through. the rapid development of multifocal consolidation new in both lungs over just <num> hr on and then the subsequent improvement in most areas was accompanied by a substantial increase in heart size and some greater distention of mediastinal veins. overall findings point to a large...
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no acute cardiopulmonary process. interval increase in the left upper hemithorax opacity, which may be intraparenchymal or a pleural plaque. recommend further evaluation with a chest ct. stable leftward deviation of the trachea, likely from thyroid goiter. when the chest ct is performed for the left upper lung opacity,...
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in comparison to study of , there is little change and no evidence of acute cardiopulmonary disease. cardiac silhouette is enlarged without vascular congestion, pleural effusion, or acute focal pneumonia.
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no acute intrathoracic process.
MIMIC-CXR-JPG/2.0.0/files/p18991843/s55691067/6b8d2bde-4478c6ba-6f803100-4b031292-20b4d9b9.jpg
small bilateral pleural effusions. right lower lobe opacity may represent atelectasis however infection is also possible.
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no acute cardiopulmonary process.
MIMIC-CXR-JPG/2.0.0/files/p10488677/s52036813/3f55d0f7-0dc66853-e05378eb-ea4820d4-a6f3d6ad.jpg
worsening cardiomegaly now moderate to severe. small pleural effusions and pulmonary vascular congestion without frank pulmonary edema. no evidence of pneumonia.
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no acute intrathoracic process.
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new retrocardiac opacity may reflect atelectasis or consolidation in the proper clinical context.
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compared to prior chest radiographs since , most recently. no radiographic evidence of pneumonia. lungs essentially clear. mild cardiomegaly and heavy mitral annulus calcification are chronic. no pulmonary vascular abnormality. patient has had median sternotomy and coronary bypass grafting involving at least left inter...
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moderate pulmonary edema, partially layering right pleural effusion. picc line and feeding tube in place.
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no acute cardiopulmonary process. unchanged enlargement of the main pulmonary arteries. mild cardiomegaly is unchanged.
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no acute cardiopulmonary abnormality.
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overall the appearance of the lungs is worsened compared to prior. while this could be due to an atypical asymmetric pulmonary edema, an underlying infectious infiltrate cannot be excluded
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probable mild cardiomegaly. mild chf. increased are retrocardiac opacity is concerning for early consolidation.
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interval improvement in the airspace opacities bilaterally, most suggestive of resolving pulmonary edema.
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no evidence of acute cardiopulmonary abnormalities.
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stable bilateral lower lobe opacities and left effusion.
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ng tube tip extends beneath the diaphragm, off the film.
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small right apical pneumothorax with a small amount of hemorrhage adjacent to a fiducial marker in the right upper lobe.
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new right basilar opacity concerning for pneumonia. probable small bilateral pleural effusions and left basilar atelectasis.
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no acute cardiopulmonary process. chronic obstructive airways disease. moderate cardiomegaly.
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the very peripheral portion of the right basal pigtail pleural drain is unchanged in position since. change the change in its course on yesterday's radiograph suggested sharp angulation that could have been obstructing. that section of the drain is not imaged fully today. moderate largely dependent but probably loculat...
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left pic line can be traced only as far as the peripheral third of the left brachiocephalic vein. very low lung volumes exaggerate heart size which is probably mildly enlarged. lungs are clear and pulmonary vasculature is unremarkable. there is no pneumothorax or pleural effusion.
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pa and lateral chest compared to : lungs are clear, heart size is normal and there is no pleural abnormality.
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as compared to the previous image, the lung volumes have slightly decreased. there is retrocardiac atelectasis but no evidence of pleural effusions, pulmonary edema or pneumonia. the tip of the endotracheal tube still projects approximately <num> cm above the carina and could be advanced by approximately <num> cm.
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mild interval increase in left lower lobe atelectasis and pleural effusion. right swan-ganz catheter is close to pulmonic valve.
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intra-aortic balloon pump is low with the tip being at least <num> cm below the roof of the aortic arch and should be advanced with least <num> to <num> cm. there is interval development/progression of substantial pulmonary edema. rest of the findings are unchanged.
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no acute cardiopulmonary process.
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small right pneumothorax has minimally decreased. there is improved aeration of the right lung. cardiomediastinal structures are midline. no other interval change from prior study.
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somewhat low lung volumes and increased vascular congestion with mild edema. persistent small right pleural effusion and adjacent pulmonary opacity which may reflect compressive atelectasis or infection.
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no evidence of acute cardiopulmonary process. nonvisualization of the previously described <num> mm right lower lobe nodule, suggesting that this finding was likely secondary to the pulmonary vasculature.
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heart is within normal limits of size. given patient rotation, the mediastinum is likely within normal limits. the aorta is quite unfolded and tortuous on the current examination, but this is felt to be related to patient positioning. lungs appear grossly clear. no pleural effusions, pulmonary edema or pneumothorax. bo...
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in comparison with the study of , the cardiac silhouette is more prominent and the pulmonary vessels are less well defined, consistent with increase in pulmonary venous pressure. no definite pleural effusion or acute focal pneumonia.
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no acute cardiopulmonary process.
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small right and moderate left pleural effusions enlarged since exam. bibasilar atelectasis. previous esophageal stent now in the stomach. suggest abdomen ct to complement findings of yesterday's chest ct showing gas in the gallbladder and biliary drains.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process.
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no signs of pneumonia or chf.
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left lower lobe opacity is likely atelectasis. pulmonary vascular congestion.
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ap chest compared to , increase in size of the now large right pneumothorax and the medial migration of the right pleural catheter suggests that the drain is fissural and isolated from the rest of the pleural space, as suggested in the report of yesterday's chest radiograph. lungs are clear. mild cardiomegaly is uncha...
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in comparison with the study of , there is little change. cardio mediastinal silhouette is within normal limits and there is no evidence of vascular congestion or pleural effusion or acute focal pneumonia. mild pleural thickening is seen in the apical region. of incidental note is cervical spine fusion hardware.
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new probable mild-to-moderate volume overload or heart failure, although a superimposed pneumonia cannot be excluded. recommend conventional pa chest radiograph for further evaluation of the lower lung opacities if the patient can tolerate it.
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no pneumonia.
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pa and lateral chest compared to : normal heart, lungs, hila, mediastinum and pleural surfaces.
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in comparison with the earlier study of this date, the right pigtail catheter has been removed and there is no evidence of pneumothorax. otherwise, little change.
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left pleural effusion has decreased in size. slight improvement of nonspecific left lower lobe peripheral opacity, which in the setting of history of pulmonary emboli, may represent pulmonary infarct. continued chest x-ray followup is suggested in <num> weeks to assess for resolution.
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ap chest compared to : right hemidiaphragm is still elevated relative to the left. could be a tiny right pleural effusion, and lung bases partially hidden, but the imaged portions of the lungs are clear, top normal heart size is stable, cardiomediastinal silhouette is unremarkable. no pneumothorax. chest cta performed ...
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no new focal consolidation.
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minimal, if any, left pleural fluid.