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/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p18335994/s53763438/c8445113-e357dc30-0bf34683-24867b73-1943193d.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p13899151/s52505015/3c14edbe-1be6eea3-00a1c833-3e210e76-14e32c39.jpg
chest findings within normal limits, no secondary metastases suspicious lesions identified.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p17799996/s52079595/93f692c4-f953f2d4-45494441-37e007ff-3995199b.jpg
substantial decrease of right sided pleural effusion and continued left pleural effusion.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p18607304/s55181800/81811988-a74596a3-f950d46b-827b8063-c1a37344.jpg
no radiographic evidence of acute intrathoracic process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p12786944/s58856040/bc840d58-70387f3b-9369a7cb-762f365d-0500c684.jpg
improving linear atelectasis left lung base. no new areas of opacity to suggest pneumonia.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p18160222/s59135977/a1d710ec-b5242054-c49ce926-3a009915-3cab6728.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p10245890/s58985968/7ac375f8-0ce34c87-ef79eea7-64e3e208-b35d4802.jpg
mild increased interstitial markings and engorged pulmonary vasculature suggest mild interstitial pulmonary edema. the heart obscures at least <unk>% of the lungs, and lateral view would be helpful in assessing for retrocardiac consolidation.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p14953864/s51732675/dd78ff3e-e8971995-128c2132-b24d52dc-e43b8900.jpg
findings of diffuse chronic interstitial lung disease without evidence of superimposed acute cardiopulmonary process. a non-urgent hrct could be performed for further evaluation.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p17130991/s53722512/3ff1bf22-f0d212f4-27612df8-a3df6520-6488977d.jpg
no acute cardiopulmonary abnormality.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p10904848/s55144816/89ad51ec-bbcb95af-65511f2d-8f8cebdd-62dd5e1f.jpg
stable postsurgical changes status post left upper lobectomy with volume loss in the left lung. no new focal consolidation is seen to suggest pneumonia.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p16512720/s52545819/d96df392-b4d0f519-1e2d0107-2fdf222b-ccda7f3e.jpg
pulmonary edema with small bilateral pleural effusions and more dense opacity at the right lung base which could represent superimposed infection.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p16928445/s56061265/8b8795a0-c14fd2d2-049f4805-50dfe00c-920ba5c2.jpg
no signs of pneumonia.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p18869142/s51540280/391afdb7-8e0d7720-d05ba198-a78ffb10-d050b8b1.jpg
no acute cardiopulmonary abnormality.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p18588613/s50490501/cebd806a-2cd032f0-7c9fa2c8-a15e147f-2c2dd868.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p14472994/s50741143/5a12f32b-cbfd95e7-753a3baf-5e070f21-3269f8d5.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p13464967/s53251919/fe5a84d5-1542b8e8-6512ccd0-28905b9f-b2a89b71.jpg
mild pulmonary vascular congestion without frank pulmonary edema. mild bibasilar atelectasis.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p17610521/s54884910/95a758d6-06d5ba79-0977c191-22332505-7fa1ea50.jpg
new small right pleural effusion with adjacent atelectasis.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p14786570/s50329457/d654938b-a897d088-7629a910-44b33081-58fa3cf4.jpg
no evidence of acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p14717765/s58919243/661360dc-6b9d6491-ffd43a16-6b9a26f4-b203b082.jpg
cardiomegaly with mild vascular congestion.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p11556551/s53546250/f37c0495-9eeb9771-469259a9-4fb398e1-107625eb.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p12956279/s59680171/06fda35c-7e699be0-1629a298-24ddccd9-88a9fe58.jpg
<num>. a left picc ends at the cavoatrial junction. <num>. bilateral lower lobe opacities are new since <unk> and could represent atelectasis, aspiration or infection. pa and lateral views in deep inspiration are recommended.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p11424467/s51992781/e010e296-8da82ed0-fb893ce4-57864385-323f52f4.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p16924675/s50045366/d205b10c-599719c9-9196ae7a-714d9e88-eed27bf3.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p19900981/s54874835/9a14f088-e39f84af-8061aed9-d95da08d-941b4136.jpg
subtly increased density at the posterior left lung base suspicious for pneumonia versus acute chest syndrome.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p13666088/s59987993/f86e6ae0-23047adc-3d8cad4c-e5da99f3-8ef407cf.jpg
small pleural effusions. improved pulmonary vascularity.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p14025287/s57416265/2fb6a099-967f75ac-750e9cff-771eeaec-41036c37.jpg
no acute cardiopulmonary abnormality.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p10418908/s59040720/1ea67e73-51729f8b-ccb9b855-bbde1f63-d220f4a7.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p15326328/s53766224/c3264810-67316f8b-1bc94843-ef0cb86d-fc43ad46.jpg
no acute cardiopulmonary abnormality.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p10670818/s53034851/6a9f1dc4-1f4b61de-5397eac4-3a621b2c-8b3f2cc3.jpg
increasing opacification of the lung parenchyma bilaterally concerning for widespread pneumonia. stable support lines and tubes.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p16676544/s51657808/92bdd7eb-3bf0bc6d-c9bb909c-ec0e019c-40365b29.jpg
interval removal of picc line. stable cardiomediastinal silhouette. no acute findings.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p19482319/s56438201/dde96f36-ecf221ba-a36fd8ce-f4a89350-1f743dd9.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p11689164/s50447923/901cf944-6fce12c4-b326e9e4-f982a978-86ad4396.jpg
no evidence of acute cardiopulmonary disease.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p10909579/s58625349/55d4ef63-97669be0-90342935-1dc9682c-af97953c.jpg
no acute cardiopulmonary process. again seen nodular opacity in the right suprahilar region for which further evaluation with chest ct is again recommended. right base atelectasis.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p11904895/s57464164/ea044344-dca1cc04-38873b68-990e0488-7307eef4.jpg
small left pleural effusion
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p14622418/s50924948/c25e7dc6-9841cdf2-4bce12b1-9775cb02-0f4452c1.jpg
swan-ganz catheter terminates in the right pulmonary artery, unchanged in position compared to prior radiograph from <unk>.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p17639355/s51759196/b1d21e3d-0426aebc-549d20f2-20d1c7ed-7be17cad.jpg
<num>. stable, mild, biapical pleural scarring. <num>. no acute cardiopulmonary abnormality.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p18017335/s51585284/cbbb5f38-49c04186-232bf598-9d15f773-1a0d04dd.jpg
<num>. endotracheal and enteric tubes appear to be in standard positions. <num>. left internal jugular vascular sheath is kinked at the level of the neck, and tip is within the low left internal jugular vein. <num>. low lung volumes with possible mild pulmonary vascular congestion and bibasilar atelectasis. <num>. unch...
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p11778436/s57271503/b28cd50c-a3282e44-105880d4-5b2119ca-86c7a3d7.jpg
no evidence of residual pneumothorax. increased subcutaneous gas along the right chest wall.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p12612019/s59460256/db9234b2-8fc5e602-cafe6c50-a89faa1c-b117ec64.jpg
no evidence of acute cardiopulmonary disease.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p17076416/s50444408/4d1d0d38-833b46f4-d84079f8-f8eac1d3-b61364a7.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p19472874/s51532685/d02489a2-c4b44aa8-8bec5e72-b95c5ce9-245ddd1b.jpg
<num>. lower lung opacity, which is a combination of loculated effusion, atelectasis and/or consolidation, is minimally better since <unk>. <num>. minimal pneumomediastinum is consistent with recent pericardiocentesis. <num>. mild-to-moderate right pleural effusion appreciated on chest ct dated <unk> is not really appr...
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p14256965/s55786345/0b9913f6-aa7c1c52-e89c4c40-b36b641c-a5672662.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p19607507/s51141903/ce170d50-210397c3-6f914d10-73db9bfb-8cbd1e22.jpg
persistent large bilateral effusions and mild pulmonary edema.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p11224611/s50182966/8f2ca465-ea5d58ae-c86b1cba-08958440-b36473c1.jpg
<num>. persistent elevation of the right hemidiaphragm. <num>. no evidence of hilar lymphadenopathy.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p12784489/s54066541/7f52f058-c64a59de-a6859a5a-3fc2c3f5-b11c7d43.jpg
no acute cardiopulmonary abnormalities stable appearance of the mediastinum
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p16994680/s50933843/db89a522-809aac07-79aec357-d8a093dc-45cade27.jpg
no acute cardiopulmonary abnormality.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p11401718/s59578120/8409cef3-ffde2cad-24470947-b7141ada-d326c55a.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p14095761/s55581382/7b1b1b74-67da432a-72231ab4-e605db06-54851b13.jpg
no acute cardiothoracic process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p13416326/s51761680/514f0e24-0f141f69-93b23f2d-80f48329-a2bf6277.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p19578341/s51276604/06a7eb92-d89ce410-4f184d34-b7e5115e-027cac89.jpg
no evidence of acute cardiopulmonary disease.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p13707575/s51604314/b6a4cc86-b6786e76-50a84b03-f2438641-d1b0196f.jpg
no acute intrathoracic abnormalities identified.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p18100158/s59249946/08349648-0bbb5e8f-cdc16557-74939ef6-9753ea45.jpg
moderate right apical pneumothorax and moderate to large right pleural effusion.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p10737228/s51441115/56578ec5-9f0aa7ec-b4afeccb-1914448b-6bab905d.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p11096180/s59978205/de4b48ed-6c098525-5a88abb1-f25e0300-e0394ab3.jpg
no acute cardiopulmonary abnormality.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p10998537/s53522158/d6dbdd5e-37d62469-8917229f-0de54df1-65b6e20b.jpg
new small right middle lobe opacity concerning for infection.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p10062615/s52604980/bfcd27b9-9b516e4c-b859f286-847ee1f1-e0215aa6.jpg
no acute intrathoracic process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p18391447/s56144441/c65676fe-ffe15f9a-cf87ac9c-2fcc8d24-bb6a6287.jpg
as above.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p16681170/s52372341/c0ca3389-a1f9bf0c-de712dcb-573878e5-4ae45774.jpg
diffuse chronic interstitial markings in the lungs without superimposed acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p10826310/s51428603/80713d79-62deae34-dfb0714e-0ca5a65e-b5975d2f.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p16773746/s54478415/60a58563-f1d67c73-0fc463be-f65149df-97fd2b07.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p13714231/s56290972/cccdbd23-7a0e0814-685b516b-2832b903-ba928ccc.jpg
bilateral lower lung pneumonia, not substantially changed compared to prior study from <num> days ago.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p17622334/s59670498/84137bd8-335fc094-4f2b9d1b-2b099585-d169bef3.jpg
<num>. no free peritoneal air is visualized but the supine position may prevent accurate detection of free air. <num>. stable chest radiograph. recommendation(s): if clinically necessary, ct chest can further evaluate for the presence of peritoneal free air.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p13849733/s58414605/b80c8698-bd19b3ad-2bfa7ec4-e5c4a4ae-ddc9c4f4.jpg
status post right-sided thoracentesis with still a moderate layering right pleural effusion. no evidence of pneumothorax.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p13871573/s51811413/4cb6986e-f4aadcca-e5276e5d-db1803b5-73e23497.jpg
no acute intrathoracic process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p19213219/s57651580/c28a5ead-f89bb01a-6e938b4f-c03bae50-7402a56b.jpg
findings most consistent with moderate interstitial pulmonary edema, accompanied by pleural effusions. attenation in follow-up suggested regarding more confluent opacity at the right lung base although edema is again the suspected etiology; coinciding pneumonia is not excluded, however.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p13552058/s51695457/4fd2f203-a59da829-1ce9ae68-82fced79-7407657e.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p10787566/s56953209/da44a5d1-eff218da-c2f72e6c-00655158-b3240682.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p18031120/s54514442/d3ec6372-07074adf-d274af95-c81d6d29-f8f60ed6.jpg
right picc terminates in the mid svc. subtle opacity at the right base may represent subsegmental atelectasis.clinical correlation advised.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p19566352/s56070114/e3212c6c-9bafdd94-f6a0bc83-1057deff-e36b9c67.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p19247836/s59185383/7067f425-cd7a873e-2d96c3a3-1c85f39f-f4174166.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p19722050/s51569569/129baae4-293c9fd1-49c130bc-002969a9-7de58da0.jpg
no acute cardiopulmonary abnormality.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p14592916/s56524133/64a09e04-5f0aa885-85d1fbae-ee5fb63f-5cedf9c3.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p13453412/s59946240/87e2d4f7-098465d6-db3a384e-33bf7c9d-2643f85b.jpg
findings consistent with mild to moderate pulmonary edema.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p18768608/s57434108/da30ce26-e9a076d1-aca7fc99-4ee56a1e-d850807d.jpg
no acute cardiopulmonary process. top normal heart size.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p12138569/s57176672/e398eb4f-660b75b9-355b8c8e-395f47ee-8600d001.jpg
bilateral pulmonary edema, worse on the right.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p11550610/s55444068/15a66b57-c1049162-4c25888e-b7731406-4e029039.jpg
no significant interval change. no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p18650767/s51810656/002e21e9-6ecacef5-325860be-30deee10-ab14092c.jpg
persistent ill-defined opacity within the right lower lobe. this finding should be further investigated with a chest ct given its continued presence.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p17354170/s56387131/df4044b8-6d9e18e6-25dfe5ec-79c30e58-fb5b303c.jpg
no evidence of acute disease.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p18025609/s53196443/a4036953-73f0ecba-7881d6c5-cc553414-bbd74b54.jpg
no acute cardiopulmonary process.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p19181583/s59068552/e470f31a-12badb6a-b8438444-0e88e5f3-54df275a.jpg
<num>. right upper lobe, and possibly right middle lobe pneumonia. given upper lobe involvement, risk factors for tb should be evaluated. the appearence may also fit with allergic bronchopulmonary aspergillosis. <num>. <num>cm calcified liver lesion is, in retrospect, unchanged since <unk> when it appears incidentally ...
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p16285590/s57324436/d23fbea4-78705b87-0268c10b-dce6428c-50f8a52e.jpg
left pigtail pleural catheter without reaccumulation of pleural fluid. no change from the prior radiograph.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p11526744/s51059431/604f7019-d9a76f65-7ede09c1-b4371b91-7763b605.jpg
no evidence of acute disease.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p17266832/s59246265/b60cceec-09153ad4-aa1ef87b-c8f07c6d-54da8009.jpg
<num>. stable appearance of right perihilar opacity. <num>. stable small/minimal left pleural effusion, now with minimal tracking intrafissural fluid. <num>. stable right lower lung zone nodule.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p18879099/s50345014/b6233a0c-9ccabd79-a6fc725c-9ef42998-77f3e8f5.jpg
no pneumonia
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p15031428/s54274781/85dd5e97-b8b047e2-e560711b-18e43c1b-044add47.jpg
subsegmental bibasilar atelectasis. moderate to large hiatal hernia.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p11303447/s51361702/c42582c0-de7a140c-8f538ae9-15a0108d-b24de033.jpg
chest findings within normal limits. no evidence of cardiovascular or pulmonary abnormalities in this nonsmoker, atypical chest pain.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p11819377/s55102629/276d185c-cea8f3fc-57cc8e39-c127355d-3e983124.jpg
right apical opacification, which is been more fully evaluated on the recent cta neck. mild pulmonary edema. small bilateral pleural effusions. mild cardiomegaly. prominent pulmonary arteries suggest pulmonary arterial hypertension.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p16521649/s57754423/f91eb9e5-74f5326b-d57c89b1-addd7b8f-938b8b65.jpg
widening of the superior mediastinum due to thyroid goiter with tracheal narrowing, better assessed on the recent ct exam. mild pulmonary vascular congestion and small left pleural effusion.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p13226810/s54103046/57dda876-01053b63-f7d90e6f-c1b2ccef-fe4e79ce.jpg
no acute cardiac or pulmonary findings.
/mnt/data/chayan/MIMIC-CXR-JPG/2.0.0/files/p12572699/s56832915/e260e63f-d085da10-79fd15a9-8bf6f03e-a5b9b750.jpg
no acute cardiopulmonary process.
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no acute cardiopulmonary process.
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no evidence of acute cardiopulmonary process.
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<num>. increased bibasilar opacities likely reflect atelectasis with a possible component of bronchiectasis. an early infectious process, however cannot be entirely excluded in the appropriate clinical setting. <num>. increased anterior posterior diameter of the chest cage is suggestive of copd. findings discussed with...
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no active disease.
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decompensated heart failure.
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known pulmonary metastases. possible mild superimposed vascular congestion.
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no acute cardiopulmonary process.
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left base atelectasis. blunting of the left costophrenic angle, trace pleural effusion not excluded. underlying consolidation difficult to exclude. no pneumothorax seen.
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<num>. left chest tube has progressively retracted toward the left chest wall, compared with <unk> and <unk>. the side port remains at over the lung itself. <num>. small to moderate left pneumothorax seen in the upper left lung, best appreciated medially and laterally, similar, but possibly slightly larger than on <unk...
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no acute cardiopulmonary process.