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There is a right ij line with tip in the svc just above the cavoatrial junction. The et tube and ng tube have been removed. There is some minimal volume loss at the bases but no infiltrate. There is a tiny right pleural effusion.
<unk> year old man with cardiogenic shock // any interval change in pulm effusions, are chest tubes in appropriate position?
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The radiograph was requested to assess for free intraperitoneal air. Based on the presence of partially layering bilateral pleural effusions, this appears to be a semi-upright rather than fully upright radiograph. Thus, a left lateral decubitus radiograph or repeat fully upright radiograph of the chest is recommended to assess for free intraperitoneal air. Indwelling support and monitoring devices are in standard position, and overall appearance of cardiomediastinal contours, lungs and pleura are unchanged since the recent chest radiograph.
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As compared to the prior examination dated <unk>, there has been minimal interval change. There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities are detected.
chest pain.
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There are no significant changes compared to the most recent cxr performed yesterday morning. The right apical pneumothorax has remained stable. No evidence of tension. Chest tube is unchanged in position and terminates in the right apex. Linear opacities in rul represent post-surgical changes. There is also a small right pleural effusion with adjacent atelectasis. Within the left hemithorax, there is a small left pleural effusion; otherwise, the left lung is free of consolidations or pneumothorax. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.
<unk> year old woman with recurrent r ptx post blebectomy // check interval change
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Ap portable upright chest radiograph was obtained. Again seen is stabilization hardware and a right-sided fractured <unk> rod, unchanged from prior exam. There are multifocal scattered opacities in the right lung. The left lung is clear. There appear to be no pleural effusions, although the right costophrenic angle is not fully imaged. No pneumothorax is seen. The cardiomediastinal silhouette is stable. No bony abnormality is identified.
shortness of breath and hypotension. evaluate for pneumonia.
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The cardiac, mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. Slight elevation of the left hemidiaphragm compared to the right may reflect volume loss. Otherwise, the lungs appear clear. Mild rightward convex curvature is centered along the lower thoracic spine.
chest pain and shortness of breath.
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Portable semi-upright radiograph of the chest demonstrates low lung volumes, which results in bronchovascular crowding. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax, pleural effusion, or consolidation. Old healed left-sided rib fracture is again seen.
history: <unk>m with hypoxia // eval pna
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The inspiratory lung volumes are appropriate. Streaky opacities in the right lung base are compatible with atelectasis. The lungs are otherwise clear without evidence of focal consolidation concerning for pneumonia. There is no overt pulmonary edema. The pulmonary vasculature is not congested. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits and unchanged. No pneumothorax is seen. Multilevel degenerative changes are again noted in the thoracolumbar spine. Lumbar spinal hardware is incompletely evaluated. There are healing fractures of the left posterolateral eighth and ninth ribs, which are new from the prior study. A left-sided pacemaker with two leads terminating in the right ventricle and right atrium is not significantly changed.
persistent productive cough, here to evaluate for pneumonia or evidence of heart failure.
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The heart is mild-to-moderately enlarged. Fullness of the right paratracheal stripe may be due to underlying tortuous vessels. Fullness of the right hilum is likely accentuated by low lung volumes. No pulmonary vascular congestion is present. No focal consolidation, pleural effusion or pneumothorax is seen. Elevation of the right hemidiaphragm is noted. There are no acute osseous abnormalities.
cough and shortness of breath.
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Lung volumes have slightly improved in the interim, but a right upper lobe opacity persists. No focal consolidation, edema, or pneumothorax. The pleural effusion seen on the chest ct from <unk> is not well appreciated on supine only view. Mild central pulmonary vascular congestion persists. Heart size is normal, unchanged. The descending thoracic aorta slightly tortuous and/or ectatic, unchanged. There is mild, broad dextroconvex scoliosis of the visualized thoracic spine. Numerous lytic lesions are better appreciated on the chest ct.
<unk> yo female w/ aggressive myeloma (tissue biopsy indeterminate), ams, presents with widely metastatic disease, pathologic fractures now being treated with velcade/dex and s/p xrt to spine, s/p l hemiarthroplasty on <unk>, with fever to <num> // please evaluate for any changes, infectious etiology of low grade temp
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Ap and lateral views of the chest are compared to previous exam from <unk>. There are ill-defined, right greater than left, increased interstitial markings throughout the lungs. There is no definite large confluent consolidation. Cardiomediastinal silhouette is within normal limits and unchanged. Median sternotomy wires again noted. Probably post-traumatic changes at the lateral right clavicle are again seen in addition to old posterior right sixth rib fracture.
<unk>-year-old male with shortness of breath. question fluid overload.
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Frontal and lateral views of the chest demonstrate low lung volumes. Moderate right pleural effusion has increased in size since prior. A small left pleural effusion is unchanged. Bibasilar opacities most likely represent atelectasis. Heart is moderately enlarged. Hilar and mediastinal silhouettes are unremarkable. Calcified atherosclerotic disease at the arch is noted. There is no pulmonary edema. Partially imaged upper abdomen is unremarkable.
patient with chest pain at the site of left pigtail catheter site.
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Heart size is borderline. The aorta is minimally unfolded. No chf, focal infiltrate, effusion or pneumothorax is detected.
syncope.
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Lung volumes are low. There is volume loss and opacity at both bases. The aorta is tortuous. The upper lungs are clear. Heart size is within normal limits.
dysphagia and the kidney.
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Chest port catheter terminates in distal svc/ cavoatrial junction. 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. The osseous structures are stable.
<unk> year old woman with locally advanced breast ca and prot in place at outside hospital, getting chemo here // is poc in appropriate position
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There is increased left pleural effusion and pleural thickening. There is minimal right pleural effusion. Diffuse nodular opacities are unchanged. No pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Right-sided port-a-cath terminates in the right atrium.
<unk> year old woman with met breast ca // numerous pulm mets. compare to prior serial cxrs
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Mild to moderate cardiomegaly is unchanged. The aorta is diffusely calcified and tortuous, similar compared to the prior exam. Mediastinal and hilar contours are unchanged. Evaluation of the lung apices is limited due to the patient's chin and soft tissues of the neck projecting over this region. Lung volumes are low. There is crowding of the bronchovascular structures but no overt pulmonary edema is present. No focal consolidation, pleural effusion or pneumothorax is clearly identified. Mild interstitial abnormality within the lung bases as well as within the right upper lung field is similar compared to the prior exam and may reflect chronic changes. No acute osseous abnormalities seen.
cough and dyspnea. history of stroke.
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The lungs are clear of consolidation. Focal nodule opacity projecting over the anterior right sixth rib is compatible with a bone island as seen on prior ct. The cardiomediastinal silhouette is within normal limits. Coronary artery stents are noted. No acute osseous abnormalities. Postsurgical changes from prior herniorrhaphy seen along the anterior upper abdominal wall.
<unk>f with hx colon ca, new chest tightness, coarse breath sounds on exam // any consolidation
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As compared to prior chest radiograph from <unk>, there has been interval improvement of pulmonary edema. There is loculation of the pleural fluid at the right lower lung base. Pleural effusions at the lung bases are otherwise unchanged. The cardiac silhouette is stable. There has been interval removal of a right internal jugular venous catheter. Sternotomy wires are intact.
<unk>-year-old female patient status post cabg. study requested for postop evaluation.
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Single frontal image of the chest was obtained. Again seen is a right-sided chemotherapy line with the tip near the mid svc. The lungs are clear bilaterally with no evidence of pulmonary congestion or pneumonia on this single frontal view. Sternotomy wires and surgical clips are again seen, consistent with history of cabg. Mild cardiomegaly is seen. There is no pneumothorax or pleural effusion.
<unk>-year-old male with myelodysplastic syndrome now with new cough and wheezing.
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Pa and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.
<unk>m with chest pain,? acute cardiopulmonary disease
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Cardiac and mediastinal contours are normal. The lungs are clear. No pleural effusion or pneumothorax is present. Minimal bi-apical thickening is present. There are no acute osseous abnormalities. No radiopaque foreign bodies are present.
possible aspirated pill.
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Single upright portable view of the chest. There are hazy bibasilar opacities, right greater than left. Blunting of the lateral costophrenic angles is also seen, potentially due to small effusions. The lungs superiorly are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified. Degenerative changes seen at the shoulders.
<unk>-year-old female with history of small cell lung cancer with acute onset of shortness of breath.
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Ap and lateral views of the chest. Somewhat low lung volumes seen with streaky bibasilar opacities suggestive of atelectasis. There is no consolidation, effusion, or pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits. Acute left clavicular fracture is better characterized on dedicated shoulder films.
<unk>-year-old female with fall and shoulder pain.
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Mild enlargement of the cardiac silhouette is relatively unchanged from the previous study. Mediastinal and hilar contours are unremarkable. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is demonstrated. No acute osseous abnormality is clearly visualized.
history: <unk>f with motor vehicle collision. chest pain, right anterior
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The right ij central venous catheter ends in the proximal right atrium. There is no evidence of pneumothorax. Cardiomediastinal silhouette is normal. Lung volumes are low with increased opacification at the bilateral lung bases left greater than right, which may represent a combination of atelectasis and pleural fluid.
<unk>-year-old man with right ij central venous catheter placement, interval evaluation.
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Bibasal consolidations appear worse compared with prior exam. There is also a new focus of a band-like consolidation extending from the left heart margin superiorly into the left mid lung. There is obscuration of the bilateral cardiac margins as well as the left hemidiaphragms. There might be a small left-sided pleural effusion. There is no evidence of pneumothorax. Aortic knob calcifications are present. Evidence of prior vertebroplasties is noted in the thoracic spine.
<unk>-year-old male with hypoxia. evaluate for evidence of pneumonia.
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The lungs are clear without focal consolidation. Obscuration of the right heart border is likely due to mild pectus deformity. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. No free intraperitoneal air per
<unk>m with appendicitis // preop
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The previously described left perihilar opacity on <unk> is likely soft tissue.the lung volumes are normal. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pneumonia, no pulmonary edema. No pleural effusions.
<unk> year old woman with ?opacity in left hilar area on cxr done yesterday. presents today with ?palpable purpura/lumps on upper and lower extremities. // r/o chest mass, infiltrate.
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As compared to the previous radiograph, the lung volumes have decreased. Non-calcified granuloma at the lateral aspect of the right upper lobe. Normal size of the cardiac silhouette. No pleural effusions. No pulmonary edema. No pneumonia. Known cervical stabilization devices.
chest pain, plan for bypass surgery tomorrow.
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As compared to the previous radiograph, the previously well-positioned picc line has been pulled back. The tip of the line now projects over the confluence of the brachiocephalic in the superior vena cava. The line should be advanced by approximately <num>-<num> cm to ensure safe position in the superior vena cava. No evidence of complications, notably no pneumothorax.
pullout of picc line.
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Large left pleural effusion, similar. Left perihilar, basilar opacification, stable, likely atelectasis. Right lung clear. Sternotomy. Benign bone island right humeral head. Suggestion of osseous loose body right shoulder joint. Surgical clips right upper quadrant.
<unk> year old woman with increasing sob and oxygen requirements with known pleural effusion // evaluate for interval change in pleural effusion.
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Overall no substantial change of the right-sided effusion and adjacent rounded opacity. Ground-glass opacities superior to the rounded opacity have slightly increased. Small left effusion is also stable. No over pulmonary edema. Moderate cardiomegaly. No pneumothorax.
<unk> year old man with right pleural effusion s/p ct guided <unk> <unk> // assess for interval change
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Low bilateral lung volumes, however slightly improved since the prior examination. There is persisting bibasilar atelectasis as well as small bilateral pleural effusions. Underlying pneumonia however cannot be excluded. No pneumothorax identified. The size of the cardiac silhouette is enlarged but unchanged.
mr. <unk> is a <unk> year-old man with dm<num>, htn, hld, pod#<unk> s/p right l<num>-<unk> microdiscectomy, who presents with confusion, fever of <num>, weakness, lower back and right leg pain concerning for ssti. now improving back pain/rle weakness. // eval for ?atelectasis (required <num>l o/n w/ <unk>% o<num>)
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The lungs are clear without focal opacities, pleural effusion or pneumothorax. The cardiac and mediastinal contours are stable.
history: <unk>f with upper respiratory tract infection and now with wheezing and shortness of breath
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Frontal and lateral radiographs of the chest demonstrate near complete resolution of right pleural effusion. In comparison to the prior radiograph, there are slightly decreased lung volumes, accentuating the cardiac silhouette and pulmonary vasculature. Otherwise, no focal consolidation is identified. Mild degenerative changes of the thoracic spine are noted.
evaluate pleural effusion.
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In comparison with chest radiograph from <unk>, a small area of heterogeneous opacity in the posteroinferior aspect of the left lower lobe suggests pneumonia. There is no effusion or pneumothorax. Mediastinal and hilar contours are normal. Heart size is normal.
<unk> year old woman with asthma exacerbation, cough w/purulent sputum. crackles at both bases // ?pna
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Dobbhoff tube has been minimally advanced in the body of the stomach, and nasogastric tube and other indwelling devices are unchanged in position since the recent study of approximately one hour earlier.
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Frontal and lateral radiographs of the chest demonstrate low lung volumes. Normal heart size. The cardiomediastinal silhouette and hilar contours are normal. The lungs are clear. No pleural effusion or pneumothorax. No displaced rib fracture identified.
dyspnea, cough and pleuritic chest pain. evaluate for infiltrate.
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The heart is normal in size. There is an dextro leftward rotation and associated with moderate this the rightward convex scoliosis but allowing for those factors, the cardiac, mediastinal and hilar contours are likely within normal range. There is no pleural effusion or pneumothorax. A geographic i density is probably pleural but laced along the lateral right hemithorax may be a manifestation of scarring or small loculated pleural effusion.
question pneumonia. patient presents with fever.
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Ap portable upright view of the chest. Midline sternotomy wires and mediastinal clips are again noted. The heart remains markedly enlarged. The lungs appear clear without focal consolidation, large effusion or pneumothorax. A tiny pleural effusion on the right is suspected. No overt edema. Bony structures are intact.
<unk>m with shortness of breath and edema // ?chf vs pna
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Previously on <unk> seen basilar (right greater than left) opacities remain and are essentially unchanged to <unk>. The right subclavian line ends unchanged in the distal svc/cavoatrial junction.
<unk>-year-old woman with apml and recurrent fevers.
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As compared to the previous radiograph, the monitoring and support devices are constant. There is minimally improved ventilation of the left and right lung base. Overall, the parenchymal opacities bilaterally are still severe in extent and severity. The presence of a small left pleural effusion cannot be excluded. No pneumothorax.
intubation, respiratory failure.
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The lungs are clear. Nodular opacity projecting over the right lung base is presumably a nipple shadow as it was not present on recent exam. Small calcified granulomas noted in the right lung. Ground-glass nodule at the left lung base seen on ct is not clearly delineated and should be followed as previously outlined. Cardiomediastinal silhouette is within normal limits. Right chest wall dual lead pacing device is again noted.
<unk>m with r sided numbness pls eval infarction
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As compared to the previous radiograph, the monitoring and support devices are in unchanged position. There is an increase in vascular markings and diameters, suggesting moderate pulmonary edema. No pleural effusions. Retrocardiac atelectasis, but no evidence of pneumonia. The referring physician, <unk>. <unk>, was paged for notification at the time of dictation, <time> a.m., on <unk>.
subarachnoid hemorrhage and herniation, intubation, evaluation for interval change.
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There are persistent small bilateral subpulmonic pleural effusions with probable associated mild atelectasis that has overall decreased. There is no evidence for free air. Additional more band-like areas of minor atelectasis project along the left mid lung at the right base without change. The heart is mildly enlarged. The patient is status post coronary artery bypass graft surgery. The mediastinal and hilar contours appear unchanged.
coffee-ground emesis and distended abdomen. question free air.
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In comparison with the study of <unk>, there is continued but slightly decreasing opacification at the right base, consistent with pneumonia. Retrocardiac opacification suggests volume loss in the left lower lobe, though supervening pneumonia can certainly not be excluded. The left subclavian picc line has been advanced to the upper to mid portion of the svc.
seizure.
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Interval placement of endotracheal tube terminating <num> cm above the carina. Enteric catheter courses below the left hemidiaphragm and out of view. Cardiomediastinal and hilar contours are unremarkable. Mild background pulmonary edema evident. Bronchial cuffing evident suggesting small airway disease or may be due to edema. No large pleural effusion or pneumothorax evident.
status post intubation. assess tube position.
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There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits.
history: <unk>f with cough, chest pain // eval for pneumonia
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Pa and lateral views of the chest are compared to previous exam from <unk>. The lungs are clear. There is no effusion or pneumothorax. The cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable.
<unk>-year-old female with back pain and chest pain. question pneumonia or pe.
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As compared to the previous radiograph, the right internal jugular vein catheter has been removed. The alignment of the sternotomy wires is unchanged. Moderate cardiomegaly, no pleural effusions. No overt pulmonary edema. No atelectasis. No pneumonia.
fevers, recent endocarditis.
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Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs. There is subtly increased opacity in the right infrahilar region compared to <unk>, without a clear correlate on lateral view. No pleural effusion or pneumothorax is seen. The visualized upper abdomen is unremarkable, with high density contrast material within the colon.
chest pain and failure to thrive.
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Ap and lateral views of the chest. Streaky linear bibasilar opacities are most suggestive of atelectasis. The lungs are otherwise clear. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified.
<unk>-year-old male with cough and hypoxia.
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There is no focal consolidation, pleural effusion, or pneumothorax. Cardiomediastinal silhouette is unremarkable. Osseous structures are intact.
chest pain, unable to tolerate foods orally.
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The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. A fracture of the proximal left humerus is incompletely assessed.
left shoulder trauma with hypotension and falling hematocrit.
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This study centered over the left hemi thorax to evaluate the nasogastric tube. The tip nasogastric tube is seen below the left hemidiaphragm in the expected location of the stomach. Endotracheal tube is unchanged in position compared to the prior study. A right-sided picc is not clearly visualized. Persistent left basilar atelectasis. Findings suggests pulmonary vascular congestion.
<unk> year old man s/p gbm resection, continued ams // ? ogt placement
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Frontal and lateral views of the chest demonstrate low lung volumes, but clear lungs. The cardiomediastinal hilar contours are unchanged. There is no pneumothorax or pleural effusion. Pleural surfaces are unremarkable. A thoracic vertebral body compression deformity is unchanged.
multiple myeloma, assess for pneumonia.
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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 history of asthma, allergies here with worsening shortness of breath
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As compared to the previous radiograph, no relevant changes seen. Bilateral, likely atelectatic changes at the lung bases are constant in appearance. Lung volumes remain low. No overt pulmonary edema. No larger pleural effusions. Moderate cardiomegaly persists.
tachypnea.
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Portable ap upright chest radiograph was provided. Several surgical clips are seen projecting over the mediastinum. There is mild pulmonary interstitial edema with mild cardiomegaly. The hila appear engorged and the interstitial markings are prominent. There are no large effusions or pneumothorax. No convincing signs of pneumonia. The mediastinal contour appears grossly within normal limits with atherosclerotic calcifications again noted at the aortic knob. The imaged bony structures appear intact.
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In comparison with the study of <unk>, there is little overall change. Again there is blunting of the left costophrenic angle, most likely reflecting pleural thickening. Some atelectatic changes are seen at the bases. However, no evidence of acute focal pneumonia. Cardiac silhouette is mildly enlarged without vascular congestion.
persistent cough for two months with yellow phlegm.
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There is small bilateral pleural effusion and bilateral lung base consolidation, which could be due to pneumonia and/or atelectasis. Increased interstitial markings are consistent with mild pulmonary edema. Cardiomediastinal silhouette is normal size. No free air is identified in the abdomen.
<unk> year old man with severe abdominal pain, dyspnea // please get upright cxr r/o free air, eval for pna
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There has been interval placement of a left-sided pacer and dual leads. The right ventricular lead overlies the left hemidiaphragm on this single view. The heart is moderately enlarged with stable in size from the prior exam. The cardiomediastinal and hilar contours are within normal limits. There is no focal consolidation, effusion or pneumothorax. No evidence of pulmonary edema with minimal pulmonary vascular engorgement.
<unk> year old woman with avj ablation and ppm placement now with severe flank/abdominal pain // eval ppm lead placement
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Ap view of the chest provided. Lungs appear more clear compared to prior study. There is no focal consolidation concerning for pneumonia. Cardiomediastinal and hilar contours are unchanged. There are no pleural effusions. Right-sided picc terminates in the low svc.
<unk>m with a history of aml s/p one cycle of decitabine currently receiving <num>+<num>, now day #<unk> with new cough and sore throat.
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Since <unk>, numerous known pulmonary nodules are again faintly seen but better evaluated on chest ct from <unk>. Lungs are clear with normal volumes. The cardiomediastinal silhouette, hilar contours and pleural surfaces are normal. No pneumothorax.
<unk> year old man with metastatic sarcoma s/p recent surgery. now with worsening fatigue/ams. // please evaluate for infectious process.
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The lungs are clear without focal consolidation, effusion, or edema. Cardiomediastinal silhouette is stable. No acute osseous abnormalities.
<unk>m with weakness // pna
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As compared to the previous radiograph, the lung volumes have slightly decreased. Unchanged appearance of the lung parenchyma and of the cardiac silhouette. No pneumonia, no pleural effusions, no pulmonary edema. Mild tortuosity of the thoracic aorta.
leukocytosis, questionable pneumonia.
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Pa and lateral chest views were obtained with patient in upright position. The heart size is normal. No configuration abnormality is present. Thoracic aorta unremarkable. No mediastinal abnormalities are seen. The pulmonary vasculature is not congested. No signs of acute or chronic parenchymal infiltrates are present and the lateral and posterior pleural sinuses are free. No pneumothorax in the apical area. Skeletal structures of the thorax grossly unremarkable. Our records do not include a previous chest examination available for comparison. Normal chest findings in <unk>-year-old male patient with history of dyspnea.
<unk>-year-old male patient without significant past medical history with dyspnea. evaluate for signs of pneumonia, edema, effusion.
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Since the prior study, the endotracheal and nasogastric tubes have been removed. Bilateral chest tubes remain in-situ. No pneumothorax seen. There is blunting of the right costophrenic angle likely reflecting residual pleural fluid. The right-sided chest tube is very close to the chest wall with a side hole just at the chest wall. No consolidation seen. The cardiomediastinal contour is unchanged in appearance. No free air seen under the diaphragm.
<unk> year old man with b/l chest tube with left chest tube to waterseal // eval for interval change; <num>am rounds
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The port can be followed at least as far as the cavoatrial junction although more distally the exact termination point is not clear due to underpenetration. A right-sided picc line terminates in the right brachiocephalic vein. Lung volumes are low. Cardiac, mediastinal and hilar contours appear within normal limits. There is a small to moderate pleural effusion on the right. It is difficult to exclude a small pleural effusion on the left. Otherwise, aside from suspected coinciding atelectasis at the right lung base, the lungs appear clear within limitations of technique.
picc line and port placement.
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Heart is upper limits of normal in size and the aorta is tortuous. Narrowing of intrathoracic trachea is present and may be postoperative in the setting of tracheoplasty procedure. Linear areas of atelectasis are present in the right mid lung. No focal areas of consolidation are evident, and there is no pleural effusion or pneumothorax. Compression deformities in the mid thoracic spine are similar to prior ct exams of this patient.
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Median sternotomy wires intact and aligned. Left pectoral pacemaker with leads terminating in the right atrium, right ventricle, and left coronary sinus. Stable cardiomegaly with pulmonary vascular congestion. No evidence of acute, focal pneumonia.
<unk>-year-old man presenting with cough. clinical concern for pneumonia.
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Since the prior radiograph, there has been development of hazy opacification of the right base, likely a small pleural effusion. Atelectasis is seen in the right lower and left lower lobes. There is mild prominence of the pulmonary vasculature and bronchial cuffing, suggestive of early chf. Mild cardiomegaly which is unchanged. An ng tube is seen with the tip within the stomach.
<unk>-year-old female, status post thrombotic right mca stroke, evaluate for interval change.
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There is elevation of the right hemidiaphragm with obscuration of the right heart border, consistent with total collapse of the right middle and lower lobes which is unchanged from prior exam. There is diffuse interstitial edema, left hilar prominence and ncreased vascular markings with upper redistribution. An associated small pleural effusion is seen in the left. Mild cardiomegaly is present and stable since <unk>. There is no evidence of pneumothorax.
<unk>-year-old female with hypoxia, right upper lobe rhonchi. evaluate for pneumonia versus failure.
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There is no focal consolidation, pleural effusion, or pneumothorax. There are low lung volumes. There is chronic scarring in the left apex and biapical pleural thickening. Cardiomediastinal silhouette is notable for a tortuous and calcified aorta. There is scoliosis of the thoracic spine.
history of left upper extremity weakness, question pneumonia.
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The pulmonary vessels appear somewhat more distinct and narrower. Accompanied by a small decrease in size of the cardiac silhouette, this is consistent with slight improvement in vascular congestion. The mediastinal contour is unchanged. No pleural effusion or pneumothorax is present. The aorta is somewhat tortuous, but unchanged. There are no focal airspace opacities to suggest pneumonia. The bones are unremarkable.
history of myeloma. chest pain. evaluate for pleural effusion or bone lesions.
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The patient is intubated. The endotracheal tube terminates approximately <num> cm above the carina. An orogastric tube has been passed into the stomach, although its tip lies below the inferior margin of the acquired film. The cardiac, mediastinal and hilar contours appear probably unchanged allowing for differences in technique including cardiomegaly. Widespread opacification suggests pulmonary edema. The left hemidiaphragm is obscured and this may be due to coinciding atelectasis but possibly pneumonia. There may also be developing focal opacity at the right lung base. There is no pneumothorax.
hypoxia, status post intubation and cpr.
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As compared to the previous radiograph, there is no relevant change. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No evidence of lung parenchymal abnormality. No pleural effusions.
radical cystectomy, preoperative chest x-ray.
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Bilateral asymmetrically distributed airspace opacities affecting the right lung to a greater degree than the left have worsened in the interval, and are likely due to a combination of pulmonary edema and pneumonia. Moderate layering right pleural effusion appears larger than on the prior study, but a small left pleural effusion is similar. Interval advancement of feeding tube, now coiling in the upper stomach.
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If there is a right apical pneumothorax it is very small. Of note, multiple cystic structures seen on recent ct scan at the right lung apex make it difficult to assess for pneumothorax. The cardiomediastinal silhouette and hilar contours are normal. No effusion is identified. <num> x <num> cm mass in the right upper lung is seen in correlates with findings on recent ct scan.
evaluate for pneumothorax.
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Comparison is made to previous study from <unk> at <time> a.m. There is a feeding tube whose distal tip and side port are within the body of the stomach. The right ij catheter has been removed. There is persistent atelectasis at the lung bases and a left retrocardiac opacity, stable.
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Since <unk>, the previously seen opacity at the level of the left fifth anterior rib persists. Furthermore, a second opacity is seen at the level of the left fourth anterior rib. Multiple peripheral ill defined possible nodules are noted in the right lung, of unclear etiology. The lungs are again borderline hyperinflated. The heart size is normal. No pleural effusion, pneumothorax, or pulmonary edema.
<unk> year old woman with pna f/u // ? pna resolution
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In comparison with the study of <unk>, the endotracheal and nasogastric tubes have been removed. Right ij catheter again extends to the mid-to-lower portion of the svc. A relatively vertical area of opacification in the left base medially most likely reflects atelectatic changes. No definite acute focal pneumonia.
productive cough.
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The examination is compared to <unk>. The picc line has been substantially pulled back. The tip, which is slightly coiled, now projects over the azygous vein and the portion of the catheter might be positioned within this vein. For secure position in the superior vena cava, the device should be either flushed or replaced. No pneumothorax. No pleural effusions, unchanged size of the cardiac silhouette, unchanged sternal wires after valvular replacement.
status post craniotomy, evaluation of picc line catheter.
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Lines and tubes: none. Ekg leads overlie the anterior chest wall. Lungs: the lung volumes are low. Again identified are linear opacities in the right lower lobe, likely atelectasis. There is no definite consolidation. Pleura: there is no pleural effusion or pneumothorax mediastinum: there is persistent cardiomegaly. Aortic knuckle calcification is again identified. Bony thorax: there is an old healed fracture involving the posterior right seventh rib. Otherwise bony thorax demonstrates no significant interval change.
<unk> year old woman with new sob // any interval change?
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Moderate right and small left pleural effusion with adjacent linear opacities. No pulmonary edema. Mild cardiomegaly. No pneumothorax.
<unk> year old woman with tips placed last week for recurrent pleural effusion // please assess for pleural effusion
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In comparison with the study of <unk>, the patient has taken a much better inspiration. Cardiac silhouette remains enlarged with tortuosity of the aorta. Pulmonary vascularity is essentially within normal limits and there is no evidence of acute focal pneumonia.
wheezing and shortness of breath.
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Two frontal portable chest radiograph were obtained. An endotracheal tube terminates <num> cm above the carina. The balloon expands the upper trachea. An enteric catheter extends inferiorly out of the field of view. The lungs are well expanded and clear. There is no focal consolidation, effusion, or pneumothorax. Dual-chamber cardiac pacing leads remain in expected positions.
hypotension.
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Right-sided port-a-cath is again noted. The lungs remain clear without focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.
<unk>f with cough s/p chemo // eval for pna
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Interval placement of bilateral chest tubes. Persistent small right hand moderate left pneumothoraces without midline shift. A right apical cap is again seen as well as marked right mediastinal widening. Right lung and retrocardiac opacities correspond to pulmonary contusions seen on ct. An endotracheal tube terminates approximately <num> cm above the carina. Previously described fractures are grossly unchanged.
<unk>f with mvc, bilateral pigtail placement*** warning *** multiple patients with same last name! // evaluate for improvement of pneumothoraces
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Pa and lateral views of the chest are provided. Comparison with <unk> radiograph. Midline sternotomy wires are again noted. Calcified curvilinear structure along the base of the heart is again noted, likely reflecting an old infarction with no aneurysm formation. There is evidence of emphysema. No signs of pneumonia or chf. No pleural effusion or pneumothorax. Bony structures are intact.
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Frontal chest radiograph demonstrates no significant change from multiple priors. Again seen is moderate cardiomegaly and mild pulmonary vascular engorgement. There is no large pleural effusion or pneumothorax.
fever shortness of breath.
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There has been progression of the right-sided airspace opacity, this is bilateral but asymmetric. Given a predominately perihilar distribution, this is likely due to pulmonary edema. The heart is not grossly enlarged, within the limits of the projection technique. There is likely a small right-sided pleural effusion. No pneumothorax seen. A right-sided internal jugular catheter terminates in the mid svc. A nasogastric tube is in-situ, the tip is not visualized lies below the left hemidiaphragm.
<unk> year old man with free air in his abdomen, now with dyspnea // cardipulmonary process
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Frontal and lateral views of the chest. Right greater than left apical scarring is again seen. There is a new small left pleural effusion. The lungs are clear consolidation or pneumothorax. The cardiac silhouette is enlarged which has progressed since prior. Hypertrophic changes are noted in the spine. No displaced rib fractures identified.
<unk>-year-old female with fall. question pneumothorax or pneumonia.
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There has been interval removal of a chest tube. The moderate bilateral pleural effusions are stable. There is a left-sided pic line which appears to terminate in the lower svc. The diffuse pulmonary edema is stable. The heart size is normal. The hilar and mediastinal contours are stable.
<unk>-year-old female, status post left vats, washout, and decortication for a left empyema, who presents for evaluation of pneumothorax, status post chest tube removal.
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As compared to the previous radiograph, the patient remains intubated and nasogastric tube is in unchanged position. A zone of increased radiodensity at the right lung base could be the result of projection but should be kept under close observation, given the possibility for developing pneumonia. No pulmonary edema. No pleural effusions. No pneumothorax.
aspiration
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Frontal and lateral views of the chest are compared to previous exam from <unk>. Streaky bibasilar opacities are seen, more so on the lateral view. Superiorly, the lungs are clear. The cardiomediastinal silhouette is within normal limits. Osseous structures are unremarkable.
<unk>-year-old male with cough, fever and congestion.
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Previously seen left upper lobe and lingular consolidations have resolved in the interval. No new focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are grossly stable.
history: <unk>m with hx of htn presented with headache //
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In comparison with the study of <unk>, there is no appreciable pneumothorax. Continued enlargement of the cardiac silhouette with opacification at both bases consistent with pleural fluid and atelectasis. Mild indistinctness of pulmonary vessels again could reflect some elevation in pulmonary venous pressure.
cabg, to assess for left pneumothorax.
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Frontal and lateral views of the chest were obtained. There is continued mild increase in interstitial markings bilaterally suggesting moderate pulmonary edema. There is an opacity along the lateral left mid-to-lower hemithorax which may be due to pleural thickening, also seen on the prior study. Superomedial to this, there is patchy opacity in the left mid lung seen on the prior study, although new since <unk>. There may be trace bilateral pleural effusions as blunting of the posterior costophrenic angles is seen on the lateral view. No pneumothorax is seen. There has been interval decrease in right base opacity. The cardiac and mediastinal silhouettes are stable and unremarkable. Previously seen dense calcifications over the mid mediastinum are no longer seen. Left axillary stent is also not seen, but may not be included on the image.