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Lung volumes remain low. Heart size is mildly enlarged, not substantially changed in the interval. Mediastinal and hilar contours are similar. Pulmonary vasculature is not engorged. Increased interstitial opacities are again demonstrated within the lung bases as well as within the mid lung fields bilaterally, not substantially progressed in the interval. No new focal consolidation, pleural effusion or pneumothorax is identified. Elevation of the right hemidiaphragm is chronic. No acute osseous abnormalities are demonstrated.
history: <unk>f with shortness of breath
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Patient is known with head and neck cancer with bilateral pleural effusions that are longstanding, moderate on the right side and small on the left side with biapical stable minimal pneumothorax. Left-sided chest tube is in unchanged position projecting in mid left hemithorax. Bibasilar heterogeneous opacities are unchanged since <unk> and could represent atelectasis however a superimposed infection or aspiration cannot be excluded. Right-sided picc line ends in lower svc. Mediastinal and cardiac contours are normal.
patient with dyspnea after vomiting, concern for aspiration.
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There are <num> right-sided chest tubes, which appear unchanged in comparison to the prior chest radiograph, without evidence of pneumothorax. The sternotomy wires appear intact and appropriately aligned. Unchanged appearance of right loculated pleural effusion with compressive atelectasis. The left retrocardiac opacity persists. Heart size is stable. The mediastinal and hilar contours are stable. The pulmonary vasculature is normal. There are no acute osseous abnormalities.
<unk> year old man with ct // ct
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Low lung volumes with kyphosis of the thoracic spine causing sub optimal assessment of the lung bases. Linear opacities in the left lower lobe extending to the hilum are new. Moderate hiatal hernia. No pleural effusions or pneumothorax.
<unk> year old woman with cough, fever // pneumonia?
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The lungs are hyperinflated. There is no opacity worrisome for pneumonia. There is however focal somewhat linear opacity projecting over right upper lung and the anterior second rib. It is not clearly visualized on the lateral view. There is no effusion or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality.
<unk>f with chest pain // ? pna
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Heart size is normal. The mediastinal and hilar contours are unremarkable without evidence of pneumomediastinum. Minimal atherosclerotic calcifications are noted at the aortic knob. Lungs are hyperinflated. No focal consolidation, pleural effusion or pneumothorax is present. Fusion hardware within the lumbar spine is partially imaged. No acute osseous abnormalities detected.
history: <unk>f with food bolus - preprocedure film
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Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Subtle opacity involving the right middle lobe may represent an area of infection. No pleural effusion or pneumothorax is seen. A nodular density is seen in the mid, left lower lobe is consistent with known mass, better characterized on prior pet-ct. As before there are streaks of fibrosis seen in the bilateral lungs consistent with posttreatment changes.
<unk>m with cough // r/o pna
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The heart is normal in size. There is a retrocardiac consolidation with air bronchograms in the left lower lobe, consistent with pneumonia. Elsewhere, the lungs appear clear. There is no pleural effusion or pneumothorax. The bony structures are unremarkable.
shortness of breath and fever.
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Frontal and lateral chest radiographs were obtained. There has been interval removal of bilateral chest tubes. The right apical pneumothorax has increased in size and the left apical pneumothorax is unchanged. There is stable mild bibasilar atelectasis and small right pleural effusion. The cardiomediastinal contours are stable. The stomach is no longer distended.
patient is status post bilateral vats, now with chest tube removal, rule out pneumothorax.
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Frontal and lateral chest radiographs were obtained. The right lung is nearly completely collapsed due to central obstruction and a large pleural effusion. Multiple nodules are present in the left lung, consistent with known metastatic disease. There is no pleural effusion on the left. There is no pneumothorax. Heart size difficult to assess due to intraparenchymal abnormalities.
metastatic lung cancer and cough, assess right pleural effusion.
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Frontal and lateral views of the chest were obtained. Lung volumes are low, exaggerating heart size. Cardiomediastinal contours are stable. Indistinct right costophrenic angle may represent a small right pleural effusion. No focal consolidation or pneumothorax. Sternotomy wires are intact.
<unk>-year-old male with peripheral vascular disease here with leukocytosis. evaluate for infiltrate.
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Supine portable view of the chest demonstrate low lung volumes. The left lung base consolidation, may represent atelectasis. No pleural effusion or pneumothorax. Pneumomediastinum and subcutaneous gas in the supraclavicular areas bilaterally extend to superiorly neck. No focal consolidation. No intraperitoneal free air.
<unk>f w/hiatal hernia, <unk> ulcers, and small bowel nodule (benign on bx) now s/p lap hiatal hernia repair w/fundoplication // evaluate for ptx, to be done in pacu
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As seen on prior, there is diffuse interstitial abnormality compatible with bronchiectasis and scarring. There are more confluent regions of consolidation at the right lung base in the middle lobe and in the right suprahilar region. There is no effusion. The cardiomediastinal silhouette is stable. No acute osseous abnormalities.
<unk>f with chest pressure, cough, dyspnea // eval for pna
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In comparison with the study of <unk>, there is little change in the position of the transvenous pacer, the tip of which appears to be in the region of the apex of the right ventricle. Cardiac silhouette is mildly enlarged and there may be minimal engorgement of pulmonary vessels. Relative opacification of the left base could reflect pleural fluid or technical artifact. Of incidental note are surgical clips overlying the outer aspect of the lower left chest, most likely related to the breast.
transvenous pacer placement.
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As compared to the previous radiograph, the lung volumes have increased. Moderate cardiomegaly. Moderate bilateral pleural effusions with subsequent areas of atelectasis. Mild fluid overload, but no overt pulmonary edema. The monitoring and support devices are constant in position.
status epilepticus, current intubation.
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An endotracheal tube terminates at the right mainstem bronchial orifice. An orogastric tube tip is within the stomach. Cardiac silhouette size is severely enlarged. Mediastinum is widened superiorly which is compatible with lipomatosis as seen on the previous ct. Bibasilar airspace opacities, more pronounced on the left, likely reflect areas of atelectasis as seen on the previous ct, though infection in the left lower lobe is not completely excluded. There are no large pleural effusions with mild lateral pleural thickening bilaterally secondary to fat. Mild pulmonary vascular congestion may be present. No pneumothorax is identified.
history: <unk>m with altered mental status, intubated
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Pa and lateral views of the chest were obtained demonstrating clear lungs bilaterally without focal consolidation, effusion, or pneumothorax. The heart size is normal. Mediastinal contour and hilar configuration are normal. Bony structures are intact. No free air below the right hemidiaphragm. Clips are noted in the right upper quadrant.
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Heart size is mildly enlarged. Mediastinal contour is unremarkable. The hilar contours are difficult to evaluate due to presence of widespread bilateral patchy consolidations compatible with multifocal pneumonia. There is no large pleural effusion or pneumothorax.
respiratory failure.
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Frontal and lateral views of the chest were obtained. Right lower lobe consolidation is worrisome for pneumonia. The left lung is clear. There is no pleural effusion or pneumothorax. The cardiac silhouette is top normal. Mediastinal and hilar contours are unremarkable.
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Since the prior study, there has been interval placement of a biventricular icd with leads terminating in the right atrium, right ventricle and an epicardial lead on the left ventricle. The degree of pulmonary edema has improved since the prior study. There is no evidence of pneumothorax. No focal consolidation concerning for pneumonia is present. A small amount of atelectasis and likely a small left pleural effusion remains in the left costophrenic sulcus.
<unk>-year-old man with biventricular icd placement. evaluation for pneumothorax and lead position.
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The lung volumes are normal. Normal size of cardiac silhouette. No pleural effusions. No focal parenchymal opacity suggesting pneumonia. No pulmonary edema. No pneumothorax. Normal hilar and mediastinal contours. A known small esophageal hiatal hernia is better seen on prior radiographs and ct. The osseous structures are stable.
<unk> year old woman with possible pneumonia // follow up
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Moderate left pneumothorax is minimally increased compared to <num> hr prior. Left basal pleural drain is shifted in position and possibly slightly pulled out by <num> cm or less compared to before. No new consolidation is identified. There is no large pleural effusion. Cardiomediastinal silhouette is normal size.
<unk> y/o female with hx of mi s/p rca stent, htn, present with chief complaint of dyspnea on exertion as well as loss of appetite. large l pleural effusion s/p chest tube placement. on water seal as of <num>am. // please repeat cxr at <unk> to evaluate for interval change, ptx. thank you
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In comparison with the earlier study of this date, the two new chest tubes are in position. The right one curves downward with the tip apparently posteriorly in the costophrenic angle. The left extends to the apex and then slightly turns downward. Extensive subcutaneous gas bilaterally makes it somewhat difficult to evaluate for possible pneumothorax. Nevertheless, there does appear to be a small apical pneumothorax on the right. The previously noted fractures are greatly obscured by overlying subcutaneous gas.
chest tube has replaced.
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There is no consolidation, pleural effusion or pneumothorax. No pulmonary edema. Cardiomediastinal contours are normal. No acute osseous abnormalities identified. No subdiaphragmatic free air.
<unk>-year-old male with jaundice
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Borderline heart size. Unfolding of the thoracic aorta, but no focal aneurysmal malformation. No airspace consolidation. No pleural effusion. No pneumothorax. Vascular occlusions coils noted.
<unk> year old man with ams // r/o pna
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An icd device is located in left pectoral position. The course of the wires is unremarkable, one wire projects over the right atrium, the other one over the right ventricle. No evidence of pneumothorax. No pulmonary edema. No atelectasis.
dilated cardiomyopathy, ecd evaluation.
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Cardiomediastinal silhouette including cardiomegaly is stable. Sternotomy wires and mediastinal clips are unchanged in position. Lung volumes remain low. Bibasilar atelectasis has improved. There is no focal consolidation. Mild blunting of the posterior sulcus on the lateral view may represent atelectasis or a trace effusion. No pneumothorax.
history: <unk>m recent cabg w right chest pain // eval for pna, effusion
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There is a focal opacity in the right hilum and a nodule measuring up to <num> cm in the right lung, though difficult to localize.heart size is within normal limits.mediastinal and hilar contours are unremarkable. There is no evidence for pulmonary edema, pleural effusion, or pneumothorax.post obstructive atelectasis. <num> weeks ct with contrast.
<unk> year old woman with fever and cough and chills. evaluate for pneumonia.
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In comparison with the study of <unk>, the central catheter has been removed. There is some opacification at the left base, most likely reflecting post-operative atelectatic change. No evidence of acute focal pneumonia or vascular congestion. Impression on the lower right side of the cervical trachea suggests a thyroid mass.
post-operative fever.
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Frontal and lateral views of the chest are obtained. There is bibasilar atelectasis. No discrete focal consolidation is seen. There may be very minimal pulmonary vascular congestion. The cardiac and mediastinal silhouettes are stable.
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Portable semi-upright radiograph of the chest demonstrates low lung volumes with resultant bronchovascular crowding. The cardiomediastinal and hilar contours are unchanged. There has been an interval increase in the degree of retrocardiac opacity, which may represent developing pneumonia. Right basalar atelectasis is not significantly changed. There is no pneumothorax or significant pleural effusion. Endotracheal tube is less than <num> cm from the carina. A right-sided internal jugular central venous line ends at the mid svc. The nasogastric tube ends in the stomach with the last sideport above the ge junction.
<unk>-year-old man, status post cardiac arrest, status post cooling, now with fever. evaluate for pneumonia.
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Pa and lateral views of the chest provided demonstrate no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette appears stable. Multiple surgical clips are again noted in the left axilla. Clips are also noted in the upper abdomen intact as well as a partially imaged gj tube. No free air below the right hemidiaphragm seen. Bony structures are intact.
<unk>f with upper abd pain, gastroparesis.
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In comparison with study of <unk>, there is increased opacification at the right base with the patient taking a larger inspiration. This most likely represents a combination of radiation effect and scarring, though superimposed recurrent tumor or even infection cannot be definitely excluded. Ct would be necessary to make this distinction. The left lung and upper portion of the right lung remains clear. There is a substantial hilar adenopathy bilaterally, though this appears to be reduced since the previous study and is primarily seen on the lateral projection.
rheumatoid arthritis, on methotrexate with increasing dyspnea.
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Ap view of the chest. There are low lung volumes. Calcified nodules in the right lung base are unchanged from prior, likely sequelae of prior healed infection. There is bibasilar atelectasis. No focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable.
hypotension, frequent falls. question infection.
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Pa and lateral chest radiograph demonstrates clear lungs bilaterally. There is no focal consolidation. There is no pleural effusion or pneumothorax.
<unk>-year-old female with cough and syncope.
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Frontal and lateral views of the chest. Prior right pic is no longer visualized. The lungs are clear of focal consolidation, effusion, or pulmonary vascular congestion. Of note, the right posterior costophrenic angle is excluded from the field of view. Cardiomediastinal silhouette is within normal limits. Old right lateral rib fractures are noted. No acute osseous abnormality is seen.
<unk>-year-old male with fever and diabetes.
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No focal consolidation, pleural effusion or pulmonary edema is present. There appeared to be reticular nodular changes particularly at the right lower lobe, which probably correspond to atelectasis. The heart is not enlarged. There is no pleural effusion. There is no pneumothorax. The aorta is slightly tortuous.
altered mental status and dizziness.
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Frontal and lateral views of the chest were obtained. Thoracolumbar scoliosis is seen. There is relative opacity projecting over the right upper hemithorax/upper lung at the level of the mid right clavicle, which may be due to overlapping structures and/or underlying scarring. However, ap lordotic view of the chest would be helpful for further evaluation. There is mild bi-apical pleural thickening. Suggestion of pleural line along the left lung apex is seen and a tiny left apical pneumothorax is difficult to exclude. Cardiac and mediastinal silhouettes are stable.
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Portable chest radiograph when compared to previous examination <unk> demonstrates interval extubation. A right picc is seen terminating in the mid to low svc, constant in position. There is improved aeration of the right lower lobe with persistent layering effusion at the left base and associated atelectasis. There are no new focal consolidations. There is no pneumothorax. The cardiomediastinal and hilar contour remains constant. There is persistent mild vascular congestion.
<unk>-year-old female status post hip surgery with respiratory failure. evaluate interval change.
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No previous images. The heart is normal in size and there is no evidence of vascular congestion, pleural effusion, or acute focal pneumonia.
anorexia nervosa.
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Indwelling support and monitoring devices remain in standard position. Lung volumes are extremely low, accentuating cardiac silhouette and bronchovascular structures. Apparent worsening lower lung pleural and parenchymal opacities may at least in part be due to differences in lung volumes. Similarly, apparent worsening vascular engorgement could be due to accentuation by low volumes. With this in mind, repeat radiograph performed at a higher lung volume setting would be helpful for more direct comparison to previous exams.
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In comparison with the study of <unk>, the patient has taken a better inspiration and there is no evidence of acute pneumonia, vascular congestion, or pleural effusion. Specifically, no evidence of pulmonary or skeletal metastases.
to assess for metastases.
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Ap single view of the chest has been obtained with patient in sitting semi-upright position. Analysis is performed in direct comparison with the next preceding similar study of <unk>. The patient is now extubated. Right internal jugular sheath and swan-ganz catheter have been removed. The same holds for the previously identified two mediastinal drainage tubes and bilateral chest tubes advanced from below. On the present portable chest examination, no remaining indwelling lines or catheters can be identified. Postoperative heart size remains unchanged and no new pulmonary abnormalities are seen. No pneumothorax is identified in the apical area.
<unk>-year-old female patient with bypass surgery, evaluate for pneumothorax following chest tube removal.
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There has been interval placement of a nasogastric tube which is seen coursing below the diaphragm and curving to the right of the spine, likely within the stomach. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. The pulmonary vasculature is not engorged and there is no overt pulmonary edema. The cardiomediastinal contours are within normal limits. Thickening of the right paratracheal stripe is not progressed from <unk>. There is no free air beneath the right hemidiaphragm.
obstructing right colon mass.
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The lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal contours. The lung parenchyma shows normal structure and transparency. No evidence of pneumonia, no pulmonary edema.
cough and leukocytosis, rule out pneumonia.
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Ap view of the chest provided. Left-sided chest tube has been removed. There may be a tiny left apical pneumothorax. There is new substantial subcutaneous emphysema on the left, concerning for possible air leak. Right upper lobe atelectasis continues to improve. Cardiomediastinal and hilar contours are stable. There are no large pleural effusions.
<unk> year old woman s/p lul resection, evaluate for pneumothorax post ct removal
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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 acute fracture is seen. The bilateral acromioclavicular joints appear intact.
history: <unk>m with fall // eval for left and right clavicle fracture
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Normal lung volumes. Mildly enlarged size of the cardiac silhouette without pulmonary edema or other lung parenchymal changes. No pneumonia, no pleural effusions. No hilar or mediastinal abnormalities. In particular, the right upper lobe appears unremarkable.
cough for six weeks, expiratory ct, evaluation for pathology, in particular in the right upper lobe.
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The lungs are clear of focal consolidation, pleural effusion or pulmonary edema. The heart size is normal. The mediastinal contours are normal.
<unk>-year-old female with altered mental status. evaluate for pneumonia.
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No previous images are available, so that comparison cannot be made with previous studies. There is enlargement of the cardiac silhouette with indistinctness of engorged pulmonary vessels consistent with pulmonary vascular congestion. Some hazy opacification at the bases could reflect layering effusion, though it could also be a manifestation of the size of the patient and resulting scattered radiation. Right ij catheter tip extends to lower portion of the svc.
copd and chf.
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Pa and lateral chest views have been obtained with patient in semi-upright position. Comparison is made with a similar pa and lateral chest examination obtained on <unk>. The previously described cardiomegaly persists, rather unchanged. Position of previously described permanent pacer in left anterior axillary position unaltered. The pacer is connected to a single intracavitary electrode. The distal terminal wire enforcement is well identified and appears in unchanged position as identified on pa and lateral chest views. The distal point of the electrode points to the left and anteriorly which is indicative of the apical area of the right ventricle. Comparison of the pulmonary vasculature as seen on the frontal view demonstrates that the previously existing perivascular haze has decreased indicating improvement of pulmonary venous congestion. No new parenchymal infiltrates are seen, the pleural sinuses are free and no pneumothorax exists in the apical area.
<unk>-year-old male patient with history of cardiomyopathy, chf, lv ejection fraction <unk>% and atrial fibrillation. patient is status post icd implant on <unk>. check ventricular lead position as today the ventricular lead threshold is significantly higher.
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Patient is status post coronary artery bypass graft surgery. Single-lead pacemaker device appears unchanged. The heart appears mild to moderately enlarged. Cardiac, mediastinal and hilar contours appear stable. There is a similar mild to moderate, diffuse interstitial abnormality. Most likely etiology is interstitial pulmonary edema without substantial change. There is no pleural effusion or pneumothorax.
congestive heart failure and shortness of breath.
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Stable chronic blunting of the right costophrenic angle most likely reflects pleural thickening. No large pleural effusion is seen. There is no pulmonary edema. No pneumothorax is seen. Subtle haziness over the lateral right mid chest may be due to overlying soft tissue. No definite focal consolidation is seen. The cardiac and mediastinal silhouettes are stable.
history: <unk>m with strong cardiac hx w/ sscp since <unk> this am // eval ? edema, mediastinal abnormalities
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The lungs are clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. No bony abnormalities are identified.
patient with unsteady gait. evaluate for infiltrate.
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In comparison with study of <unk>, there is still some increased opacification at the left base, consistent with a resolving pneumonia. Tracheostomy tube remains in place.
possible pneumonia in patient with fever.
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There is volume loss in the right lung with right basilar atelectasis. With a small right pleural effusion cannot be excluded. A right internal jugular catheter terminates in the mid to distal svc. An endotracheal tube terminates approximately <num> cm above the level the carina. A nasogastric tube terminates with the tip just beyond the gastroesophageal junction, this could be advanced several cm for better seating within the stomach. No consolidation or pneumothorax seen.
<unk> year old woman with new ett // eval ett placement
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The patient is status post sternotomy. A dual-lead pacemaker/ icd device appears unchanged. The heart is moderately enlarged. The aortic arch is calcified. There is perihilar haziness which is worse than on the prior study with probable pleural effusions, likely small or small-to-moderate in size. Findings are consistent with pulmonary edema.
hypotension and cough on dialysis.
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In comparison with the study of <unk>, the patient has taken a somewhat better inspiration. Cardiac silhouette is within upper limits of normal in size. There is improving vascular congestion with layering pleural effusions and mild atelectatic changes at the bases. The endotracheal tube tip lies approximately <num> cm above the carina. Nasogastric tube extends well into the stomach where it crosses the lower margin of the image.
arrest.
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Et tube is in standard position, the tip is <num> cm above the carina. Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion.
<unk> year old man with hematemesis s/p intubation // eval ett
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Blunting of the right costophrenic angle could represent atelectasis, and no corresponding blunting is appreciated on the lateral view. Linear markings in the left lung base are again noted, likely representing scarring or atelectasis. There is no evidence of focal consolidation, pulmonary edema or pneumothorax. The heart and mediastinal contours are normal.
<unk>-year-old female with dyspnea, chest tightness. evaluate for pneumonia, effusion or secondary signs of pulmonary embolism.
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Frontal view of the chest was obtained. The heart is of top normal size. Mediastinal contours are unremarkable. Lungs are clear without focal consolidation, pleural effusion, or pneumothorax. No radiopaque foreign body.
<unk>-year-old female with palpitations. evaluate for cardiomegaly.
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A vague opacity is seen at the left lung base on the frontal view with no clear correlate on the lateral view. There is no pleural effusion, or pneumothorax. Multiple calcified granulomas are seen throughout the lungs bilaterally. The hilar and mediastinal contours are normal. The heart size is normal.
history: <unk>m with chest pain // ?pneumonia
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Frontal and lateral views of the chest. Linear opacity at the left lung base suggestive of atelectasis. The lungs are otherwise clear without consolidation or effusion. The cardiomediastinal silhouette is within normal limits. There is a an acute appearing left lateral likely <num>th rib fracture.
<unk>-year-old female with shortness of breath and cough. where fracture.
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Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. No subdiaphragmatic free air is present.
history: <unk>m with left upper quadrant abdominal pain and left sided chest pain
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With the patient's neck in flexed position, the endotracheal tube ends high, <num>-<num> cm above the carina. Consider advancing the endotracheal tube by <num>-<num> cm for appropriate seating. Orogastric tube ends in the stomach and right internal jugular line terminates at cavoatrial junction, and are appropriate. Bilateral lung volumes remain low. Mediastinal and pulmonary vascular congestion is unchanged. Bilateral lower lung atelectasis, left side more than right, is similar. There is no pulmonary edema or pleural effusion. Dr. <unk> discussed findings related to endotracheal tube position with icu rn by telephone at <time> p.m. On <unk>.
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The lungs are clear. The cardiac and mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. Interval removal of the left subclavian central venous catheter and right picc.
recent cva, status post craniotomy. presenting from rehab with increased lethargy and headache. evaluate for acute process.
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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.
<unk>f with copd, p/w l blurry vision <num> week ago, ?tia // please evaluate for any acute process
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Again noted is a bulky mediastinal mass. No pleural effusion or pneumothorax is seen status post mediastinoscopy. Bibasilar atelectasis is present, particularly on the left without evidence of focal consolidation worrisome for pneumonia.
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There is a small right-sided pleural effusion. Adjacent consolidation is likely could combination of atelectasis and infection. More rounded consolidation seen in the right mid lung, likely right middle lobe. Elsewhere, lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.
<unk>m with r sided cp // r/o pna
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There is an orogastric tube in place seen coursing below the diaphragm. The tip is not included on this radiograph but is at least in the stomach. The et tube is <num> cm from the carina. Again seen are bilateral diffuse parenchymal opacities that are mostly unchanged from the prior study. Cardiomediastinal silhouette is difficult to evaluate due to opacities. Median sternotomy wires are intact.
<unk>-year-old man with new og tube placement, question og tube placement.
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Portable upright chest radiograph was obtained. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The heart and mediastinal contours are unremarkable with unchanged enlargement of right hilar consistent with known calcified lymph nodes. Amorphic density along the right humeral head suggests calcific tendinitis.
copd and wheezing.
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The lungs are normally expanded and clear without focal airspace opacity to suggest pneumonia. The aorta is again tortuous and unfolded. The heart is top normal in size. The hilar and mediastinal contours are stable. There is no pleural effusion or pneumothorax. Surgical clips project over the upper abdomen. There are mild-to-moderate degenerative changes in the thoracic spine.
chest pain. evaluate for pneumonia, effusion.
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Ap upright and lateral views of the chest provided. There is persistent left perihilar opacity which is not significantly changed from the prior exam and may reflect known lung cancer or treatment related scarring. No definite signs of pneumonia. No pleural effusion or pneumothorax. Heart size is normal. Bony structures remain intact. No free air below the right hemidiaphragm.
<unk>f with c/o cough and "flu like sx" and hx lung ca // ? pna
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Patient is status post median sternotomy, aortic valve replacement, and cabg. As before, the superior mediastinal wire remains fractured. Heart size is mild to moderately enlarged, unchanged. Mild interstitial pulmonary edema is decreased in extent compared to the previous study. Minimal blunting of left costophrenic angle suggests a trace pleural effusion. No focal consolidation or pneumothorax is identified.
history: <unk>f with chest pain
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Lung volumes are low. The lateral contour of the descending aorta and inferior left heart border are indistinct, which may be secondary to technique and body habitus as well as low lung volumes with atelectasis; however, focal consolidation and pneumonia cannot be definitely excluded in the appropriate clinical situation. No pleural effusion. No pneumothorax. The heart size appears enlarged, which may in part be secondary to technique. There is mild cardiovascular congestion.
<unk>-year-old woman with shortness of breath on bipap; evaluate for pneumonia.
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The lungs are well inflated. Mediastinal clips and median sternotomy wires, as well as aortic arch calcifications are unchanged. There is no pleural effusion, pulmonary edema, pneumothorax, or focal consolidation. Right glenohumeral degenerative change with osteophyte formation is again noted.
history: <unk>m with shortness of breath // eval for pna
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A single frontal upright view of the chest was obtained portably. Right basilar opacity is new from <num> days prior. Additionally, pulmonary vasculature is engorged with increased interstitial markings, right more than left, with exacerbaton of chronic right hilar vascular dilatation. There is no pleural effusion or pneumothorax. Moderate to severe cardiomegaly persists. The upper mediastinal silhouette is normal. Surgical clips in the right breast are again seen.
cough and dyspnea.
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In comparison with study of <unk>, what appears to be the right-sided picc line has its tip just outside the rib cage. Obliquity of the patient somewhat obscures detail, though the overall appearance of the heart and lungs is quite similar to the prior examination.
picc line pulled by the patient.
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Evidence of pleural plaques are again seen, particularly on the left. Lung volumes are low. Basilar atelectasis is seen without definite focal consolidation. There is no pneumothorax or pleural effusion. The cardiac and mediastinal silhouettes are stable.
history: <unk>m with ams // eval for pna
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Right-sided pigtail terminates at the medial right lung base. There has been no significant interval change in the opacification of the mid and lower right lung secondary to large loculated pleural effusions with adjacent atelectasis as described on the recent chest ct. Superimposed infection cannot be excluded. Mild left basilar atelectasis is persistent. There is no evidence of a pneumothorax.
history of loculated pleural effusions and pneumonia. please evaluate for interval change.
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Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.
history: <unk>f with chest pain.
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The cardiomediastinal and hilar contours are normal. There is no pneumothorax or large pleural effusion. The lungs are well-expanded, and a new small opacity at the right lung base medially is concerning for an infectious process. The upper abdomen is unremarkable.
<unk>m with dyspnea, cough // ?pna, ptx
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The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac cardiac silhouette is mild to moderately enlarged. The aorta is calcified and tortuous. There is a large hiatal hernia with large air-fluid level seen.
history: <unk>m with incresaing confusion // eval for pna
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Median sternotomy wires appear intact. A left chest wall pacer-defibrillator has leads terminating in the right atrium and right ventricle. Numerous surgical clips project over the anterior mediastinum from prior coronary artery bypass. Lung volumes are slightly low similar to the prior study. Previous pulmonary edema is significantly improved except for residual and some atelectasis in the lung bases. There is no large pleural effusion or pneumothorax. Moderate cardiomegaly is unchanged. The mediastinal and hilar contours are normal.
chest pain. evaluate for pneumonia or pneumothorax.
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Pa and lateral views of the chest demonstrate low lung volumes. Tiny bilateral pleural effusions are new since <unk>. No signs of pneumonia or pulmonary vascular congestion. Heart is top normal in size though this is stable. Aorta is markedly tortuous, unchanged. Aortic arch calcifications are seen. There is no pneumothorax. No focal consolidation. Partially imaged upper abdomen is unremarkable.
shortness of breath.
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Comparison is made to previous study from <unk>. There is cardiomegaly. There are bilateral pleural effusions, left greater than right. There is a prominent gastric air bubble at the left base. There is minimal prominence of the pulmonary interstitial markings without overt pulmonary edema. There are no focal pneumothoraces.
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Since <unk>, new left swan-ganz catheter is seen with the tip seen either folding back into the right ventricle or passing into the left pulmonary artery. Additionally, a new endotracheal tube is identified with the tip positioned <num> cm above the carina. There is unchanged appearance of substantial left retrocardiac opacification with associated pleural effusion. Cardiomegaly is unchanged. Right internal jugular central venous line terminates in the right atrium. No pneumothorax.
<unk> year old man with new ett, cvls // line/tube placement
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Ap view of the chest. There is a small amount of subcutaneous air along the left lateral chest. The mentioned rib fractures are not well evaluated on this study. Bibasilar atelectasis. Previously seen pneumothorax is not well seen. There is an abnormal mediastinal contour explained by mediastinal fat on ct.
multiple left rib fractures, small pneumothorax, evaluate for interval change.
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Previously seen left upper lobe nodular opacity is not as well seen in this exam, but it probably represents focal calcification at the first rib costochondral cartilage. There is mild atelectasis at the left lung base, similar to prior. There is no pleural effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits and unchanged.
<unk> year old woman hld, htn, <unk>'s esophagus, gerd, anemia, now hospitalized with obstructive renal failure and uti with lul nodule on admission cxr; persistent hypotension // monitoring for interval changes of lul nodule
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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.
history: <unk>m with motorcycle accident // eval for traumatic process
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In comparison with the study of <unk>, there is possibly some mild decrease in the area of increased opacification in the mid portion of the right lung and lower zone. Small area of lucency in the right hilar region could conceivably represent cavitation, though this could also merely be superimposed interstitial and vascular markings. Blunting of the costophrenic angle persists with a right pigtail catheter in place. There is suggestion of a lenticular area of pneumothorax laterally just adjacent to the mid lung opacification. Continued enlargement of the cardiac silhouette with evidence of pulmonary vascular congestion. Monitoring and support devices remain in place. This information has been conveyed to dr. <unk>, <unk> for dr. <unk>, by telephone on <unk> at <time> a.m., <num> minute after discovery.
multifocal pneumonia, to confirm line placement.
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Fine reticular lung markings are not appreciably changed since <unk>, and likely reflected chronic interstitial abnormality in the setting of emphysema. The lungs are mildly hyperinflated. There is no new consolidation or pleural effusion. Mild cardiomegaly is stable. Generalized osteopenia and spinal degenerative changes have slightly progressed, including a chronic mid thoracic vertebral body compression fracture.
<unk> year old woman with history of ? pulmonar nodule and ?bronchiectasis presents with one week of productive cough // please evaluate for pneumonia
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Frontal and lateral views of the chest were obtained. As also seen on the subsequent ct abdomen and pelvis, there is a <num> cm left lower lobe pulmonary nodule which is worrisome for malignancy, either primary or metastatic. Trace right pleural effusion seen on subsequent abdomen ct was better appreciated on that study. Slight prominence of the interstitium as compared to the prior study may be due to development of interval mild interstitial edema. The cardiac and mediastinal silhouettes are stable. Retrocardiac air-fluid level is most consistent with hiatal hernia.
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The et tube terminates approximately <num> cm above the carina. Nasogastric tube traverses below the diaphragm with the tip likely in the body of the stomach. The heart size is normal. There is mild perihilar vascular congestion. Regions of opacity in the right upper and lower lung may be secondary to aspiration. There is no pneumothorax or large pleural effusion. The visualized osseous structures are unremarkable.
history of altered mental status. please evaluate for pneumonia. patient is status post ingestion of multiple pills of unknown quantity.
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Frontal and lateral views of the chest. The lungs are clear without focal consolidation, effusion or pulmonary vascular congestion. Moderate cardiomegaly is similar in appearance compared to prior. Atherosclerotic calcifications noted at the aortic arch. No acute osseous abnormality is identified.
<unk>-year-old female with history of thoracic aneurysm.
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Pa and lateral views of the chest were obtained demonstrating clear well-expanded lungs without focal consolidation, effusion, pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. There is no free air below the right hemidiaphragm.
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No previous images. The cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia. There is apparent calcification in coronary vessels as well as the area of the mitral annulus.
diabetes with end-stage renal disease.
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Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.
history: <unk>f with chest pain
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Pa and lateral views of the chest were reviewed. The cardiomediastinal and hilar contours are stable. Again noted is a left pacemaker with leads terminating in the right atrium and right ventricle as expected. There is no pneumothorax. There is a small right pleural effusion with atelectasis. Underlying consolidation at the right lung base cannot be excluded. There is no left pleural effusion. Slight increase in interstitial markings diffusely may represent interstitial edema versus an atypical infection.
productive cough.
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Pa and lateral chest views have been obtained with patient in upright position and analysis is performed in direct comparison with the next preceding similar study obtained two hours earlier. During the latest examination interval, a left-sided thoracocentesis has been performed and the amount of left-sided pleural effusion has been reduced markedly resulting in visibility of the left-sided diaphragmatic contour with only minor blunting of lateral and posterior pleural sinus remaining. No pneumothorax can be identified. Lungs remain aerated as before, status post thoracotomy and general aortic contour dilatation as seen earlier.
<unk>-year-old male patient with bilateral effusions, status post ascending aorta hemi-arch replacement with resuspension of his aortic valve on <unk>. status post left-sided thoracocentesis with <unk> ml evacuated. evaluate for pneumothorax.