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no evidence of acute disease.
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moderate pulmonary edema has mildly improved. cardiomegaly and widened mediastinum are stable. moderate bilateral pleural effusions right greater than left grossly unchanged allowing the difference in positioning of the patient. et tube is in standard position. right ij catheter tip is in the lower svc. ng tube tip is not clearly visualized.
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interval removal of two left-sided pigtail pleural catheters with interval appearance of a tiny left apical pneumothorax. this can be further evaluated on followup imaging. the endotracheal tube, nasogastric tube, and right subclavian picc line are unchanged in position. overall cardiac and mediastinal contours are likely stable given differences in positioning. bilateral layering effusions with associated patchy right basilar airspace disease, likely reflecting compressive atelectasis, although pneumonia cannot be entirely excluded. results were communicated to the patient's nurse, , by phone on at at the time of discovery.
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pa and lateral chest compared to : right lung volume remains low, but there is no focal lung abnormality on either side. mediastinal fat is interposed between the cardiac apex and base of the left lung. right subclavian infusion port ends in the svc. no pleural fluid or evidence of central lymph node enlargement. heart size normal. no pneumonia.
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no acute cardiopulmonary abnormalities
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no acute cardiopulmonary abnormality.
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new fiducial marker projects over the left hilus. no pneumothorax, pleural effusion, or abnormality in the left lung. patient has had right pneumonectomy.
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no acute intrathoracic process.
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no acute cardiopulmonary process.
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as compared to the previous radiograph, the lung volumes have decreased. a small right pleural effusion is present and is accompanied by bilateral new areas of atelectasis at the lung bases. there is no evidence of free intra-abdominal air or of new more mediastinum. no pneumothorax. moderate cardiomegaly persists.
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small bilateral pleural effusions are seen on the lateral view with overlying atelectasis. pulmonary vascular congestion, but improved since the prior study.
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no acute cardiopulmonary abnormality.
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in comparison with the study to, there is little overall change. again there is substantial enlargement of the cardiac silhouette with mild fullness of pulmonary vessels consistent with elevated pulmonary venous pressure. retrocardiac opacification again is consistent with volume loss in the left lower lobe and pleural effusion. the opacification at the right base, consistent with fluid and atelectasis, is less pronounced on the current study. the possibility of superimposed pneumonia would be difficult to exclude, especially in the retrocardiac region, in the absence of a lateral view. the endotracheal tube remains in good position. it is very difficult to see the lower portion of the nasogastric tube, with the tip having been pulled back to the distal esophagus. recommendation(s): because the tip of the nasogastric tube can only be followed to the distal esophagus, consideration could be given to obtaining a view of the lower chest and upper abdomen using abdominal technique to conclusively determine whether the tip of the tube extends to the stomach.
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mild pulmonary edema, which was more conspicuous on ct, with small persistent bilateral pleural effusions.
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appropriately positioned biventricular pacing device. no complications.
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endotracheal tube and bilateral internal jugular central lines are unchanged in position. status post median sternotomy for valve replacement with stable postoperative cardiac and mediastinal contours. slightly worsening diffuse bilateral parenchymal process, but more focally in the left upper lobe and at both bases. although this may represent a worsening infectious process, this all could be related to progression of pulmonary and interstitial edema. clinical correlation is recommended. no pneumothorax.
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no evidence of pneumonia.
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no acute cardiopulmonary process. results were text paged to dr at on via telephone by dr at the time the findings were discovered.
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no significant change in moderate bilateral pleural effusions.
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increased left pleural effusion with mediastinal shift to the right
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in comparison with the study of , there is little overall change. again there is enlargement of the cardiac silhouette with elevated pulmonary venous pressure in bilateral pleural effusions with compressive basilar atelectasis. in view of the extensive pulmonary changes, it is extremely difficult to exclude the possibility of superimposed pneumonia in the appropriate clinical setting, especially in the absence of a lateral view.
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stable cardiomegaly without overt pulmonary edema.
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prominence of interstitial markings perhaps age-related or reflective of a chronic lung disease. no focal consolidation or overty pulmonary edema.
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no acute cardiopulmonary process.
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new wedge-shaped opacity in the periphery of the right mid lung. while this could reflect a pneumonia, a pulmonary infarct would also be a consideration. recommendation(s): consider chest cta if concern for pulmonary embolism.
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appropriately positioned right internal jugular central venous catheter, without pneumothorax.
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no acute cardiopulmonary abnormality.
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large left pleural effusion with left basilar opacity likely reflective of atelectasis though infection is not excluded. probable mild pulmonary vascular congestion.
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no acute cardiopulmonary process.
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no evidence of acute cardiothoracic process. however, a radiolucent region with possible depression of the left hemidiaphragm is incompletely evaluated and may be artifactual. a repeat examination with pa and lateral views is recommended for complete evaluation of this region.
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no acute cardiopulmonary process.
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since the prior chest radiograph of , the patient has been intubated, with tip of tube terminating <num> cm above the carina. this could be advanced several cm for standard positioning. superimposed on pre-existing chronic pulmonary fibrosis are widespread ground-glass and alveolar opacities. these are new compared to the prior chest radiograph and have rapidly progressed since a more recent ct of. differential diagnosis includes widespread infection, acute exacerbation of ild, pulmonary hemorrhage and edema.
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findings are suggestive of pulmonary edema. persisting right infrahilar opacity.
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in comparison with the study of , the cardiac silhouette remains at the upper limits of normal in size or mildly enlarged without appreciable vascular congestion. opacification at the bases is consistent with bilateral pleural effusions and mild compressive atelectasis. dual channel pacer extends to the right atrium and ventricle.
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clear lungs.
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improving heterogeneous bilateral lower lobe opacities, which could be due to atelectasis and/or aspiration. small bilateral pleural effusions. mild pulmonary vascular congestion.
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there is no interval change. support lines and tubes are unchanged in position. there is unchanged cardiomegaly. there are bilateral effusions and a left retrocardiac opacity and mild pulmonary edema. there are no pneumothoraces.
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in comparison with the study , there has been a diagnostic wedge resection with no evidence of pneumothorax. the patient has taken a better inspiration. there are prominent interstitial markings at the bases that could be consistent with underlying sarcoidosis. no evidence of hilar or mediastinal adenopathy or acute focal pneumonia.
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severe cardiomegaly, no evidence of pulmonary edema.
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rapid evolution of diffuse bilateral confluent opacities with air bronchograms, consistent with an alveolar process. given time course, this most likely represents pulmonary edema. probable small right greater left effusions with underlying collapse and/or consolidation. cardiomegaly again noted.
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new focal opacity within right upper lung may represent summation of normal structures or a focal lung abnormality such as a lung nodule or early focus of the pneumonia. recommend degree shallow oblique view for further evaluation. recommendation(s): recommend degree shallow oblique view for further evaluation of right mid lung focal opacity.
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compared to prior chest radiographs,. right upper lobe collapse has probably improved. left lower lobe atelectasis has worsened. fullness in the mediastinum and left hilus could be due to adenopathy overload appears to have worsened since. heart is moderately enlarged. small left pleural effusion is new. chest ct scanning would give more information, but whether is appropriate depends upon clinical clinical findings with respect to cardiorespiratory status. et tube is in standard placement. esophageal drainage tube passes into the stomach and out of view. right jugular line ends in the low svc. no pneumothorax.
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no evidence of acute cardiopulmonary disease or intrathoracic injury. compression deformities of t<num> and l<num>, the latter probably unchanged, the former new and age-indeterminate although not necessarily acute. moderate hiatal hernia.
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no acute cardiopulmonary process.
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compared to previous radiograph of , multifocal pulmonary opacities have improved, particularly in the left perihilar and basilar region. small left and moderate right pleural effusions are again demonstrated. no other relevant changes.
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no acute cardiopulmonary process.
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interval decrease of right basilar opacity representing pneumonia versus infarction versus a combination of both. dilated right and left pulmonary arteries in the setting of pulmonary embolism.
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no acute intrathoracic process. , md
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no acute cardiopulmonary process.
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in comparison with the study of , there is little change. monitoring and support devices remain in place. no evidence of acute pneumonia or vascular congestion.
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no evidence of displaced rib fracture within the limitations of routine chest radiography. if further evaluation is desired dedicated rib series or ct may be obtained.
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multiple pulmonary nodules compatible with known metastatic disease. tiny right pleural effusion.
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subdiaphragmatic air not present on prior chest x-ray. probable bibasilar pneumonia.
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no acute cardiopulmonary process.
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persistent elevation/eventration of the right hemidiaphragm. evidence of large hiatal hernia. persistent moderate-to-severe compression of a lower thoracic vertebral body.
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large right pleural effusion, hemo thorax into approved otherwise, has progressed substantially since :<num> on. et tube has been withdrawn, ends <num> cm above the carina. persistent left lower lobe consolidation, either pneumonia or atelectasis. left upper lung clear. right lung obscured by effusion, still somewhat atelectatic in the upper lobe. heart size normal. right subclavian line ends in the mid svc. upper enteric drainage tube passes into the nondistended stomach and out of view.
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no acute intrathoracic process.
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diffuse pneumonia, possibly from aspiration. stable appearance of known pericardial cyst. finding #<num> discussed with dr via telephone at on.
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interval improvement but persistence of bibasilar opacities.
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no acute cardiopulmonary abnormality.
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comparison to. no relevant change is noted. normal lung volumes. borderline size of the cardiac silhouette. mild elongation of the descending aorta. no pulmonary edema. no pleural effusions. no pneumonia. no abnormalities at the level the chest wall.
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no evidence of acute disease.
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moderate-to-severe cardiomegaly and moderate pulmonary edema, increased since.
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no acute cardiopulmonary abnormality.
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no pneumothorax seen following chest drain removal.
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low lung volumes without definite acute cardiopulmonary process.
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marked cardiomegaly and pulmonary interstitial edema. left mid lung opacity may represent small mass. ct can be done for further assessment.
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pa and lateral chest compared to : there has been no appreciable change since except for development of very small amount of pleural fluid in the left chest. right lung is entirely clear. the heart is severely enlarged, causing left lower lobe atelectasis, unchanged. there is no pneumothorax and no pulmonary edema.
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increased right pleural effusion, now large, with underlying consolidation, compatible with right middle and lower lobe collapse. superimposed infection may be present.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process.
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no acute pulmonary process identified.
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compared to chest radiographs through. low lung volumes exaggerate vascular crowding. lungs are otherwise clear. heart size is normal. upper tracheal stent is in the midline on the frontal view. left trans jugular central venous infusion port catheter ends in the upper svc.
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no acute cardiopulmonary abnormalities
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no acute cardiopulmonary process.
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as compared to the previous radiograph, the lung volumes have improved, reflecting improved ventilation. this is particularly true at the lung bases, where parts of the pre-existing pleural effusions and areas of atelectasis have resolved. the left picc line is now correctly positioned. moderate cardiomegaly and mild fluid overload persists.
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low lung volumes with patchy opacities in the lung bases most likely reflective of atelectasis.
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comparison to. the right venous introduction sheet has been removed. the extent of the pre-existing left pleural effusion with subsequent retrocardiac atelectasis is stable. both the left and the right pleural effusions are better appreciated on the lateral than on the frontal view. stable mild cardiomegaly. no pulmonary edema.
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no acute cardiopulmonary process. no evidence of a rib fracture. in the setting of high clinical suspicion for a fracture, dedicated rib series may be considered for further assessment.
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right lung consolidations, most notable in the right upper , represent pneumonia or asymmetric edema. follow up radiograph is recommended after diuresis and longer-term after treatment to ensure resolution. these findings and recommendations were discussed with dr by dr by phone at on.
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low lung volumes with bibasilar atelectasis, no lobar consolidation or pleural effusion.
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there is cardiomegaly, upper zone redistribution and blurring of vascular detail consistent with chf. there is no pneumothorax, effusion or dense consolidation.
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no evidence of pulmonary edema. no significant interval change from the prior exam, with diffuse interstitial opacity corresponding to post-radiation and fibrotic changes likely related to nsip.
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heart size is top-normal. substantial spinal scoliosis is re- demonstrated. lungs are well aerated. nodular opacity projecting over the left lower lung is unchanged since the prior study and represents nipple. no pleural effusion is demonstrated. linear areas of scarring in the right mid lung are re- demonstrated. more focal opacity and potentially increased in size and density in the right upper lung is noted at should be further assessed with cross-sectional imaging.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process. no evidence of fluid overload.
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no acute intrathoracic process.
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as compared to the previous radiograph, pacemaker leads are unchanged. the tips project over the right atrium and right ventricle, respectively. the alignment of the sternal wires and the clips of the cabg are constant. normal size of the cardiac silhouette. no pneumothorax. elongation of the descending aorta. no pleural effusions. no pulmonary edema.
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no acute intrathoracic process.
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stable placement of drainage tube at or just distal to the pylorus and feeding tube terminating in the jejunum. stable residual left lower lobe atelectasis.
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views of the chest and upper abdomen shows a nasogastric tube ending in the distal stomach. swan-ganz catheter ends in the right pulmonary artery. mild interstitial edema persists. moderate cardiomegaly has improved, but mediastinal vascular engorgement is unchanged. et tube ends at the upper margin of the clavicles, no less than <num> cm from the carina. lateral aspect left hemithorax is excluded from the examination. the other pleural margins are normal, but i suspect posteriorly layering right pleural effusion at least small size. no pneumothorax.
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stable exam
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no evidence of pneumonia.
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normal chest radiograph.
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persistent right hilar mass compatible with known malignancy with worsening right lower lobe opacification concerning for postobstructive pneumonia. small bilateral pleural effusions. left basilar atelectasis.
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no acute cardiopulmonary process.
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pulmonary vascular engorgement without frank edema small bilateral pleural effusions.
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ap chest compared to : mild edema, asymmetric, favoring the right lung, is improving, but small right pleural effusion is larger. no left pleural effusion. no pneumothorax. mild cardiomegaly stable. left jugular line ends in the low svc.
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no acute intrathoracic process.
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ap chest compared to : previous mild pulmonary edema has improved since. residual opacification at the base of the left lung could have been from pneumonia or atelectasis. moderate right pleural effusion and right lower lobe collapse are unchanged since. heart is mildly enlarged, but stable. et tube is in standard position, an upper enteric drainage tube passes into the stomach and out of view. there is no pneumothorax or appreciable left pleural effusion.