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Lung volumes have decreased, and the heart continues to be severely enlarged. There is a moderate right pleural effusion with fluid tracking along the minor fissure. The low lung volumes cause crowding of the central bronchovascular structures, and there is central pulmonary vascular congestion. No pneumothorax is seen.
<unk> year old female with bradycardia. evaluate for congestive heart failure or pneumonia.
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The cardiac, mediastinal and hilar contours appear stable. Opacity along the left cardiac apex is consistent with waxing and waning minor atelectasis associated with a small epicardial fat pad. Otherwise, the lungs appear clear. There is no pleural effusion or pneumothorax.
chest pain.
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The lungs are normally expanded and clear. The heart is top normal but not enlarged. The mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. There are gas-filled loops of large bowel in the left upper quadrant.
syncope, ecg evidence of left ventricular hypertrophy. evaluate for cardiomegaly.
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Patient is status post median sternotomy and cabg. The cardiac and mediastinal silhouettes are stable. There is diffuse increase in interstitial markings bilaterally, concerning for moderate pulmonary edema versus atypical infection. No pleural effusion or pneumothorax is seen. Degenerative changes are seen at the acromioclavicular joints bilaterally.
history: <unk>f with confusion // please eval for pna
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As compared to the previous radiograph, the patient has been extubated and the nasogastric tube has been removed. The right internal jugular vein catheter is in unchanged position. The consolidation with cavitation, located in the right lung, is unchanged in extent and severity. Also unchanged are the signs suggestive of fluid overload and a small pleural effusion on the left. No change in appearance of the cardiac silhouette.
severe pneumonia, intubation, evaluation for interval change.
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The et tube terminates approximately <num> cm from the carina and must be advanced approximately <num>-cm. The heart size is normal. There has been interval improvement of the pulmonary vascular engorgement and mild bilateral pulmonary edema. There has been an interval increase in bibasilar atelectasis. Again seen is the opacity in the medial aspect of the right apical chest, unchanged from the prior exam, for which a ct is recommended for further evaluation. No new focal consolidations, pleural effusions, or pneumothoraces are identified. The hilar and mediastinal contours are otherwise unremarkable.
<unk>-year-old male with fevers, cough, chest pain, history of endocarditis who presents for evaluation of interval change.
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The lung volumes are low. No pleural effusions. Normal appearance of the lung parenchyma. No pneumonia, no pulmonary edema. No other acute changes. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures.
evaluation for acute process.
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Frontal and lateral radiographs of the chest were acquired. A <num>-mm opacity projecting over the posterior aspect of the right ninth rib could be a bone island versus a calcified granuloma within the lung parenchyma. The lungs are otherwise clear. The heart size is normal. The mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen.
chest pain. assess for pneumonia.
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The lungs are clear with no evidence of a consolidation, effusion, or pneumothorax. Cardiac and mediastinal silhouettes are normal. No acute fractures are identified.
syncope.
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Ap and lateral views of the chest are compared to previous exam from <unk>. There is diffuse increased interstitial marking seen throughout the lungs. There is however no confluent consolidation nor effusion. The cardiac silhouette is enlarged but not significantly changed from prior given differences in technique. Osseous and soft tissue structures are unremarkable.
<unk>-year-old female with cough and shortness of breath. pneumonia versus chf.
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As compared to the previous radiograph, the parenchymal opacity has substantially increased. This is stronger seen on the right than on the left, but the progression is clear for both lungs. The size of the cardiac silhouette is at the upper range of normal. There is mild-to-moderate retrocardiac atelectasis. No larger pleural effusions are identified. The left picc line is in constant position.
noncardiac pulmonary edema, evaluation for progression.
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As compared to the previous radiograph, there is a decrease in extent and severity of the pre-existing parenchymal opacities. However, the opacities are still widespread and diffusely distributed throughout both lungs. Unchanged borderline size of the cardiac silhouette and absence of pleural effusion. No new parenchymal opacities. No pneumothorax. Unchanged monitoring and support devices.
respiratory failure, evaluation for interval change.
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Frontal and lateral chest radiographs demonstrate slightly low lung volumes. The cardiomediastinal silhouette is within normal limits. Increased opacity projecting over a lower thoracic vertebral body on lateral view likely corresponds to increased opacity in the region of the right heart border. Allowing for differences in inspiratory phase, this likely corresponds to a right upper lobe pneumonia seen on ct from <unk>. No pleural effusion or pneumothorax is visualized. Right hilar clips are again noted.
history: <unk>f with cough and shortness of breath // r/o infection
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Again is seen a right suprahilar mass with a fiducial clip placed within it, the extent of which is similar to the recent prior exams. Otherwise, the heart size and mediastinal contours are normal. The lungs are clear. There is no pleural effusion or pneumothorax.
<unk>-year-old male with renal cell carcinoma and hilar mass with recent phototherapy, in need of evaluation for effusion or consolidation.
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In comparison with the study of <unk>, the left chest tube has been removed and there is no evidence of pneumothorax. Endotracheal tube and nasogastric tubes have been removed. Swan-ganz catheter remains in place. Bibasilar atelectatic changes persist with blunting of the left costophrenic angle. Small amount of subcutaneous gas is again seen along the lateral chest wall on the left.
chest tube removal, to assess for pneumothorax.
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Left basilar atelectasis is again seen. The lungs are otherwise notable for nodular densities projecting over the bases compatible with nipple shadows. There is no pneumothorax. There is no effusion or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.
<unk>m chest pain frequent flyer pls r/o ptx
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The right-sided effusion has decreased in size, now very small or possibly resolved. Cardiac size is normal. Focal patchy opacity at the right lung base is seen and a small focus of infection may be present. Right hilar adenopathy is noted to be decreasing over multiple prior exams as was seen on a pet-ct from <unk>. There is no pulmonary edema or pneumothorax.
lung cancer.
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Lungs are well-expanded and clear. The heart is not enlarged. The aorta is mildly tortuous. Hila are within normal limits. No pneumothorax, pleural effusion, or consolidation.
history: <unk>f with cough, chest pain, epigastric burning // r/o acute process
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Subtle opacification within the left lower lung, localized to the lower lobe on the lateral is concerning for early/developing pneumonia. No other focal consolidations. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.
history: <unk>f with wheezing, cough // please evaluate for acute intrathoracic process
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Frontal and lateral views of the chest were obtained. There is very minimal blunting of the bilateral posterior costophrenic angles, which is likely not significantly changed from the prior, although very trace pleural effusions are not excluded. Areas of calcification overlying the right hemithorax are in similar distribution as compared to the prior, although somewhat slightly more prominent as compared to the prior from <unk>. No definite focal consolidation is seen. There is no pneumothorax. There is a dual-lead left-sided pacemaker with leads extending to the expected positions of the right atrium and right ventricle. The cardiac and mediastinal silhouettes are stable.
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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.
cough.
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Ap view of the chest. Lower lung volumes. The left-sided pleural effusion persists, may be slightly smaller, however, persists. Tiny left apical pneumothorax. Left basilar consolidation cannot be entirely ruled out.
recurrent effusion. status post thoracentesis, question pneumothorax.
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The lungs are well expanded and clear bilaterally with no areas of focal consolidation, pleural effusion, masses, or lesions. The upper lobes demonstrate a paucity of vascular markings, and both diaphragms are mildly flattened; findings are compatible with patient's diagnosis of copd. The cardiomediastinal silhouette is within normal limits, and pleural surfaces are unremarkable. Again seen is an anterior fusion plate seen in the cervical spine, unchanged in position relative to the prior, with no obvious hardware complications.
<unk>-year-old male with history of chf, afib, copd; now presents with increased shortness of breath.
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Endotracheal tube tip terminates <num> cm from the carina. An orogastric tube is noted which courses below the diaphragm, and into the stomach, with the tip off the inferior borders of the film. Left-sided dual-chamber pacemaker device is noted with leads terminating in the right atrium and right ventricle. The cardiac, mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Streaky opacities in the left lung base likely reflect atelectasis. No focal consolidation, large pleural effusion or pneumothorax is demonstrated. No acute osseous abnormalities are seen.
intubated.
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Portable semi-upright radiograph of the chest demonstrates moderate pulmonary edema and small bilateral pleural effusions. Atelectasis versus scarring in the left upper lobe is unchanged. The heart appears top-normal in size. No pneumothorax. Please note that the ct of the chest from <unk> demonstrate a hypodense mass adjacent to the left atrium, or an unusually large thrombosed left atrial appendage and a large hiatal hernia.
history: <unk>f with acute sob and hypoxia // r/o acute process
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The heart is borderline enlarged. Allowing for technique, the mediastinal contours are within normal limits. There is a moderate interstitial abnormality suggesting pulmonary edema with small suspected pleural effusions, better suggested on the lateral view. There is no pneumothorax. Superimposed are streaky opacities in the left mid lung, possibly coinciding atelectasis. Fissures are mildly thickened.
renal insufficiency, shortness of breath, hyponatremia and worsening renal failure.
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When compared to a remote prior, there has been no significant interval change. There are increased interstitial markings best seen on the lateral view in the retrosternal region and projecting over the cardiac silhouette. There is no new consolidation, or effusion. The cardiomediastinal silhouette is stable. No acute osseous abnormalities.
<unk>m with cough, fever // r/o infiltrate
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Ap and lateral views of the chest. The lungs are clear without consolidation or definite effusion noting that the right posterior costophrenic angle is excluded from the field of view. The cardiomediastinal silhouette is within normal limits for technique. No displaced fractures identified.
<unk>-year-old male with elevated inr, status post fall.
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Pa and lateral views of the chest provided demonstrate no focal consolidation, effusion, or pneumothorax. The heart and mediastinal contours are normal. Bony structures are intact. There is no free air below the right hemidiaphragm.
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Single portable ap view of the chest was obtained. The patient is status post esophagectomy and gastric pull-through with prominent persistent right base opacity seen. Since the prior study, there has been overall diffuse increase in interstitial markings most consistent with pulmonary edema. There is blunting of the left costophrenic angle and a small left pleural effusion is likely present. The right costophrenic angle is stable in appearance. Cardiac and mediastinal silhouettes are stable.
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Ap upright and lateral views of the chest provided. The lungs appear relatively clear without convincing signs of pneumonia or edema. No pleural effusion or pneumothorax is seen. The heart and mediastinal contours appear unchanged. There may be minimal hilar congestion. Bony structures appear grossly intact.
<unk>f with agitation // evaluate for pneumonia
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Pa and lateral views of the chest were obtained demonstrating clear lungs bilaterally. No focal consolidation, effusion, pneumothorax is seen. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm is seen.
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Portable semiupright frontal radiograph of the chest. The tracheostomy tube is in expected position. Lung volumes are low with bibasilar atelectasis and likely small pleural effusions. No pneumothorax. Mild enlargement of the cardiac silhouette. The upper abdomen demonstrates gastrostomy tube in the left upper quadrant. Air is seen outlining loops of bowel on the right upper quadrant consistent with free air. Additionally pneumatosis is noted in several loops of bowel in the right upper quadrant. All of these findings were seen on outside hospital ct.
question free air.
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The heart size is normal. The mediastinal and hilar contours are unremarkable. The lungs are clear and the pulmonary vascularity is normal. No pleural effusion, focal consolidation, or pneumothorax is seen. There are mild degenerative changes in the mid thoracic spine.
shortness of breath and chest pain.
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Frontal and lateral views of the chest were obtained. The heart is of normal size. Cardiomediastinal contours are stable. Retrocardiac density with correlating opacity overlying the lower thoracic spine on the lateral view is compatible with left lower lobe consolidation. No large pleural effusion or pneumothorax. No radiopaque foreign body.
<unk>-year-old male with leg weakness and urinary hesitancy. evaluate for intrapulmonary process.
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The patient is rotated. No pneumothorax. Small focal consolidation in the left lower lung region of recent biopsy is most compatible with pulmonary hemorrhage. No pleural effusion. Stable widened appearance of the mediastinum, which may in part be secondary to rotation. Unchanged appearance of the incompletely visualized left shoulder replacement.
<unk> year old woman with lll lung mass and now s/p bronch with tbbx on the left // ptx
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Lung volumes are low. This accentuates the cardiac silhouette size which is likely mildly enlarged. The mediastinal and hilar contours are unremarkable. There is crowding of the bronchovascular structures, with likely mild pulmonary vascular congestion but no overt pulmonary edema. No focal consolidation, pleural effusion or pneumothorax is present. Mild bibasilar atelectasis is noted. There are multilevel degenerative changes in the thoracic spine. Partially imaged is a left humeral head prosthesis.
lower extremity swelling and shortness of breath.
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As compared to the previous radiograph, there is no relevant change. Very lower lung volumes with areas of bilateral basal atelectasis. On the current image, presence of minimal left and right pleural effusion cannot be excluded. Mild cardiomegaly without evidence of pulmonary edema. No evidence of pneumonia.
biliary leak, evaluation for interval change.
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Frontal and lateral views of the chest were obtained. There is mild left base atelectasis. No focal consolidation, large pleural effusion, or evidence of pneumothorax is seen. There is minimal right middle atelectasis/scarring. Wedge compression of a lower thoracic vertebral body is grossly stable as compared to <unk>. Please see thoracolumbar ct for further evaluation.
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The ett ends <num> cm above the carina. The enteric tube projects with the tip over the mid thoracic spine. Normal heart size. Opacity at the right lung base may reflect atelectasis or effusion, but could be artifactual due to patient positioning.
history: <unk>m with spontaneous sah, intubated // eval ett
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In comparison with the study of earlier on this date, there has been a placement of a pigtail catheter at the left base. No evidence of pneumothorax. No change in the substantial loculated effusion on the left. It is unclear whether the catheter extends to the area of the fluid loculation.
loculated effusion with pigtail placement.
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Single frontal view of the chest was obtained. The cardiac silhouette remains mildly enlarged. Mediastinal contours are stable. There is slight eventration of the left hemidiaphragm. No focal consolidation, large pleural effusion, or evidence of pneumothorax is seen.
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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. Thoracic scoliosis is noted.
history: <unk>f with cp, hypoxia // eval for consolidation
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Drainage tubes overlie the chest in similar position to the prior examination. A right internal jugular catheter is unchanged in position and terminates within the right atrium. Lung volumes are markedly low as before. There is bibasilar atelectasis. Mild pulmonary edema appears mostly resolved. Small left apical pneumothorax.
<unk> year old man s/p cabg // please check at <num>am on <unk> to eval for air leak with ct clamped
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As compared to the previous radiograph, the left pigtail catheter is in unchanged position. There is no indication for the presence of a left pneumothorax. However, other than on the previous radiograph, free intra-abdominal air is seen below the right hemidiaphragm. Normal size of the cardiac silhouette. Normal appearance of the lung parenchyma. At the time of dictation and observation, at <time> a.m., on <unk>, the referring physician, <unk>. <unk>, was paged for notification.
stab wound, status post pigtail placement.
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The lungs are clear. There is no consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.
<unk>f with cough // eval l pna
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Inspiratory volumes are slightly low. There is mild cardiomegaly. The aorta is calcified and slightly tortuous, similar to <unk>. There is upper zone redistribution possible slight vascular plethora, but no overt chf. The right hemidiaphragm is elevated, with crowding of vessels in the right cardiophrenic region. No discrete focal infiltrate or frank consolidation is identified. Linear densities in the lower lobe posteriorly on the lateral view are thought to represent superimposition of vascular and osseous shadows. No pleural effusion seen on either side. Tiny (<num> mm) calcified granuloma in the right upper zone laterally overlying the right fourth posterior rib. Osteopenia and degenerative change of the thoracic spine are noted. At the edge of this film, incidental note is made of degenerative changes in the shoulders.
history: <unk>f with ams // ? pna? ich
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Patient is status post median sternotomy and type a aortic dissection repair with unchanged tortuous appearance of the mediastinal contour which is widened superiorly. Cardiac silhouette size remains moderately enlarged with a coronary artery stent again noted. Hilar contours are within normal limits. The pulmonary vasculature is not engorged. Lung volumes are lower compared to the previous radiograph. Patchy opacities in the lung bases likely reflect areas of atelectasis and scarring, not substantially changed in the interval. No pneumothorax is present however the medial aspect of both lung apices is obscured by the patient's neck and chin projecting over this area. No large pleural effusion is seen. Moderate degenerative changes are noted in the thoracic spine with slight loss of height of several lower thoracic vertebral bodies, unchanged.
history: <unk>f with weakness and ecg changes // pneumonia? mediastinal widening?
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No consolidation, pleural effusion or pulmonary edema is seen, and the cardiac and mediastinal contours are normal.
<unk>-year-old woman with well-controlled hiv, and no history of aids. now with <num> week cough consistent with viral bronchitis, subjective fevers. treatment with amoxicillin. evaluate for evidence of atypical pneumonia.
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In comparison with the study of <unk>, the monitoring and support devices remain in place. Cardiac silhouette remains at the upper limits of normal in size. Some indistinctness of pulmonary vessels raises the possibility of elevated pulmonary venous pressure. The left hemidiaphragm is more sharply seen. Mild bibasilar atelectatic change. No definite acute focal pneumonia.
copd and pneumonia, to assess for change.
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Previously reported mild fluid overload has apparently resolved. Lungs demonstrate baseline abnormalities related to emphysema and chronic scarring, both most pronounced in the upper lobes and similar in appearance to a baseline chest radiograph of <unk>. Cardiomediastinal contours are also stable since that time. There are no pleural effusions. Bones are diffusely demineralized. Right internal jugular central venous catheter remains unchanged in position.
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In comparison to prior chest radiograph, the intra-aortic balloon pump is inappropriately located approximately <num>-<num> cm from superior aspect of the aortic knob. Lung volumes are stable. Unchanged bibasilar atelectasis. Stable enlargement of the cardiomediastinal silhouette. Unchanged bilateral small pleural effusions. The osseous structures are stable. The left picc line terminates in the mid svc.
<unk> year old man with subdural hematoma and stemi, evaluated for cabg // eval for interval change
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No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac silhouette is top normal to mildly enlarged. Mediastinal contours are unremarkable. There is a subtle lucency projecting at the distal left clavicle of indeterminate age, correlate with site of pain and need for additional imaging.
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In comparison to the chest radiograph obtained approximately <num> hours prior, no significant changes are appreciated. Heart size and cardiomediastinal silhouette are unchanged. No pulmonary vascular congestion or pulmonary edema or pleural effusions. The lungs are fully expanded and clear without focal consolidation. A right-sided ij sheath is unchanged in position in the upper svc.
<unk> year old woman with nstemi and heart failure // is there interval change?
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Cardiac silhouette is mildly enlarged. Previously present pulmonary edema has substantially improved with only minimal residual interstitial edema remaining. Patchy bibasilar opacities probably represent atelectasis as well as a linear focus of atelectasis in the left lung base laterally. Bilateral small pleural effusions are present, and have improved since the previous radiograph. Multifocal post-traumatic deformities are present within the imaged skeletal structures of the thorax.
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There is a left pleurex catheter with the tip not definitely seen and is likely dislodged. The multiloculated right hydropneumothorax is unchanged. There is atelectasis at the left base. There is no definite focal consolidation or pneumothorax. Cardiomediastinal silhouette is unchanged.
<unk>-year-old woman status post pleuroscopy, pleurodesis and pleurx on <unk>, now with no drainage from pleurx, question effusion.
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Left-sided picc remains in the distal svc <num> cm caudal to the carina. Heart size is normal. Cardiomediastinal silhouette and hilar contours are unchanged. Lungs are clear. There is no pleural effusion or pneumothorax.
chest pain.
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Comparison is made to previous study from <unk>. There is hardware seen in the lower lumbar spine. There is a tracheostomy tube whose distal tip is <num> cm above the carina, appropriately sited. There is a left-sided picc line whose distal tip is in the mid svc and is oblique to the svc wall. There is a feeding tube whose distal tip and side port are below the gastroesophageal junction. Heart size is enlarged. There is prominence of the pulmonary interstitial markings suggestive of minimal fluid overload. These findings are all stable.
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Frontal and lateral views of the chest demonstrate low lung volumes. There is no focal consolidation, pleural effusion or pneumothorax. There is no pulmonary edema. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. Multiple remote right-sided rib fractures noted. A surgical clip is seen projecting over right supraclavicular region.
left arm pain and cough.
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There has been interval increase in the past she alveolar infiltrates right greater than left there is a small left effusion heart size is upper limits normal there is mild pulmonary vascular redistribution
<unk> year old man with <unk> m presenting with confusion, dehydration, has metastatic likely hcc with large liver mass and lung mets, on treatment for cap. // ?worsening pneumonia
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There is no significant change from the study three and a half hours prior with moderate cardiomegaly and moderate interstitial pulmonary edema. There is no pneumothorax. No new central venous catheter is detected on this study.
femoral line. evaluate line placement.
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The heart size is normal. The aorta remains tortuous, and the mediastinal contours are stable. Pulmonary vasculature is normal and the hilar contours are unremarkable. Patchy opacity is seen within the right lower lobe which may reflect an area of infection. No pleural effusion or pneumothorax is visualized. There are no acute osseous abnormalities.
leukocytosis and fever.
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Increased retrocardiac density suggesting moderate hiatal hernia, unchanged in appearance since <unk>. There are no discrete opacities in the lungs, which are worrisome for pneumonia. There is no pleural abnormality. The tip of a left picc line is approximately at mid svc. No pneumothorax or pleural effusion. Top normal heart size, mediastinal and hilar contours are unchanged.
history of aml, clostridium difficile colitis and ulcerative colitis suspicious for pneumonia.
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The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Evidence of dish is seen along the thoracic spine.
history: <unk>f with facial and arm numbness, // evaluate for acute process
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A swan-ganz catheter ends in the region of the right main pulmonary artery. A cardiac valve is in unchanged position. Multiple surgical drains project over the mediastinum. Apparent right and left chest tubes are in unchanged position. An endotracheal tube ends in mid thoracic trachea. An apparent enteric tube is only able to be seen to the level of the distal esophagus likely due to technique. A right picc ends in the region of the low svc. Pulmonary edema has improved. Atelectasis is noted at the lung bases bilaterally.
<unk> year old man with mech avr bentall // eval for pneumothorax
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The right lower lobe opacity is less conspicuous on today's exam. Otherwise, the overall radiographic appearance is similar to the prior exam. No new focal consolidation, pleural effusion, or pneumothorax. Stable linear platelike atelectasis in the left lower lung. Stable appearance of the cardiomediastinal silhouette and hila, with a prominent central pulmonary artery. Stable hyperinflation of the lungs with flattening of the diaphragms and increase in the anteroposterior diameter of the chest.
<unk>-year-old man with hiv and a recent episode of pneumonia who now presents with fevers. evaluate for pneumonia.
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Heart size is normal. Right-sided aortic arch is again noted. Mediastinal and hilar contours are otherwise unremarkable. Lungs are clear periportal vasculature is normal. No pleural effusion or pneumothorax is detected. Rounded sclerotic focus projecting over a mid thoracic vertebral body appears unchanged from <unk>, likely a bone island. No acute osseous abnormalities seen.
history: <unk>f with fever, chills
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No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is detected. Hyperinflated lungs with underlying emphysematous changes appear similar compared to prior. Heart and mediastinal contours appear stable with calcified tortuous aorta. Lung nodules seen on prior ct are not appreciated radiographically, but ct is more sensitive for small lung nodules.
<unk>-year-old female with history of lung cancer, congestive heart failure, and hypertension, now with unsteady gait and altered mental status.
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No previous images. The dobbhoff tube extends to the distal stomach. There is mild-to-moderate enlargement of the cardiac silhouette without vascular congestion, pleural effusion, or acute focal pneumonia.
dobbhoff tube placement.
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Pa and lateral chest radiograph demonstrates numerous bilateral rib fractures with bony expansion in previously described on chest ct dated <unk>. Lungs appear grossly clear although overlying opacities involving the ribs is somewhat limiting. Increased opacity in the right paratracheal region is due to known posterior right rib fractures with expansion. There is no opacity convincing for pneumonia. Atelectasis at the left base is noted. Severe compression deformity of t<num> vertebral body which is sclerotic in appearance has been previously demonstrated. Remaining vertebral body heights appear preserved. Overlying bowel obscures lumbar vertebral bodies. Heart size is upper limits of normal. There is no evidence of pulmonary edema. There is no pneumothorax. There is no large pleural effusion.
<unk>f with r t<num> pain, hx of multpke myeloma and presumed renal cell carcinoma // ?mass, pneumonia
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Endotracheal tube and nasogastric tube are in standard position. Heart size is normal. Mild pulmonary vascular congestion is accompanied by minimal interstitial edema. Slight blunting of left costophrenic sulcus is suggestive of a small pleural effusion. Asymmetrical opacity at right lung apex is probably due to summation of normal structures given the extreme apical lordotic projection, but attention to this region on short-term followup radiograph with standard positioning would be helpful to exclude an acute lung abnormality in this region. Of note, there is no evidence of lung mass in the right apex on images of the upper chest performed as part of a ct neck exam of one day earlier.
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Pa and lateral views of the chest. At the right lung base there is pleural calcifications and chronic atelectasis or scarring. No evidence of pneumonia. The heart, mediastinum, and hilum are normal. No pneumothorax. No pleural effusion. No pulmonary vascular congestion.
dizziness and alcohol, evaluate for pneumonia.
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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>f with syncope, elevated wbc count // infiltrate?
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Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable.
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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.
*** code cord *** history: <unk>m with weakness // ?pna
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Frontal and lateral views of the chest demonstrate irregular opacity punctuated with small lucencies possibly representing dilated bronchi. This could represent asymmetric edema versus infection, and could potentially represent entities such as bronchioloalveolar carcinoma. There may also be additional opacities in the right middle and left infrahilar lungs. There is no pneumothorax or pleural effusion. There is appearance of severe emphysema. Mild cardiomegaly is unchanged. Mediastinal and hilar contours are within normal limits. A left pectoral dual-channel pacer/aicd appears stable in location with leads terminating in the right atrium and right ventricle. Upper thoracic lordosis is unchanged.
<unk>-year-old male with shortness of breath and cough. question pneumonia.
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Cardiac, mediastinal or hilar contours are unchanged and within normal limits. Pulmonary vascularity is normal. Lungs are clear. No pleural effusion, focal consolidation or pneumothorax is visualized. No acute osseous abnormality is detected.
chest pain.
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The lungs are clear. There is no focal consolidation or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.
<unk>m with s/p seizure // eval for pna
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The inspiratory lung volumes are appropriate. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. The cardiomediastinal and hilar contours are within normal limits. No acute osseous abnormality is detected. Mild dextroscoliosis of the spine is noted. There is no free air beneath the hemidiaphragms.
<unk>f with new cp // acute cv process
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Left mid to lower lung opacified is likely a combination of moderate right-sided pleural effusion with underlying atelectasis. The remainder of the lungs are clear. No left-sided pleural effusions. No pneumothorax. The visualized cardiomediastinal silhouette is normal.
<unk> year old man with urothelial carcinoma presenting with pleuritic chest pain // please evaluate for pleural effusion
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In comparison with the study of <unk>, there has been re-accumulation of pleural fluid on the left, slightly less than that on the earlier study of this admission dated <unk>. The configuration raises the possibility of some amount of loculation. Some increasing fullness of pulmonary vessels could reflect some elevated pulmonary venous pressure. Retrocardiac opacification suggests some substantial volume loss in the left lower lobe.
pleural effusion evaluation.
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Frontal and lateral radiographs of the chest demonstrate low lung volumes. Patient's known extensive pulmonary fibrosis is re- demonstrated on this radiograph. There is no definite new consolidation seen. The cardiomediastinal and hilar contours are unremarkable. There is no pneumothorax or pleural effusion.
<unk>f with pulm htn and fibrosis with worsening sob // pna?
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Left-sided dual-chamber pacemaker device is noted with leads terminating in the right atrium and right ventricle. Heart size is normal. Atherosclerotic calcifications are demonstrated at the aortic knob. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is not engorged. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is detected. No acute osseous abnormalities are present.
history: <unk>m with intracranial hemorrhage from outside hospital, chest pain
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Dual lead left pectoral pacemaker device is unchanged in position. Replaced aortic valve is unchanged in position. Median sternotomy wires are unchanged. Bilateral interstitial opacities are new from <unk>, favored to be edema and given the short interval time course of development. However concurrent pneumonia cannot be excluded in the appropriate clinical situation. The heart remains enlarged. The mediastinum is not widened. Aortic knob calcifications are mild. Slight blunting of right costophrenic angle could be a trace pleural effusion. No pneumothorax. Degenerative changes in the bilateral ac joints are moderate.
<unk>-year-old man with hypertension, intermittent chest pain and sob. evaluate for edema.
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<num> views of the chest demonstrates clear lungs. The cardiac, hilar, and mediastinal contours are normal. No pleural abnormality is seen.
syncope.
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The lungs are clear. The cardiac contour appears within normal limits. Atherosclerotic calcifications are noted at the aortic arch and the aorta is otherwise unremarkable. No acute fractures are identified. Mild degenerative changes are visualized throughout the thoracic spine.
cough and vomiting.
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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.
productive cough.
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Lungs are fully expanded and clear. No pleural abnormalities. Heart size is normal. Cardiomediastinal and hilar silhouettes are normal.
<unk> year old woman with persistent cough // rales left base
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There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal.
<unk>f with chest pain and doe // effusion? pna?
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Right-sided chest tubes are again seen. There is persistent elevation of the right hemidiaphragm. Right upper chest region of loculated gas is again seen, grossly stable in extent. There has been interval increase in adjacent right upper lung opacity which may be due to underlying pleural effusion and consolidation with possible component of collapse without shift of the mediastinum. The left lung is grossly clear aside from minor basilar atelectasis. The cardiac and mediastinal silhouettes are stable with the right aspect difficult to fully assess due to the right-sided opacities. Extensive subcutaneous emphysema is again seen tracking along the right chest wall and into the right neck.
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There is stable moderate cardiomegaly with increased upper zone redistribution, central vascular congestion, and moderate interstitial edema. Atelectasis is noted at the left lung base. No large pleural effusion or pneumothorax. Dual chamber pacer leads and sternal closure hardware is unchanged. No focal consolidation concerning for pneumonia.
history: <unk>f with dypsnea. evaluate for chf
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A right basilar pigtail catheter is present. No pneumothorax is identified. There is a persisting small layering right pleural effusion. Mild interval in decrease in the extent of the pulmonary edema. No left pleural effusion. The size of the cardiomediastinal silhouette is within normal limits.
<unk> year old man with cirrhosis found to have right pleural effusion s/p pigtail // ?status of right ptx
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Heart size is mildly enlarged, similar to the previous study. Mediastinal and hilar contours are normal. Lungs are clear. No pleural effusion or pneumothorax is seen. No displaced fractures are evident.
history: <unk>m with motor vehicle collision, c<num> pain to palpation and chest pain
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The lungs are clear. No focal consolidation, edema, effusion, or pneumothorax. The heart is normal in size. The mediastinum is not widened. The hila are unremarkable. No evidence of rib fracture. Thoracic vertebral body heights are preserved. Overall appearance of the thoracic spine on this radiograph is similar to <unk>. Anterior lower cervical spine fixation hardware grossly appear intact.
<unk>f with complains of neck pain and ribs pain. // evaluate for neck fracture, and rib fracture
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As compared to the previous radiograph, there is no relevant change. The tip of the endotracheal tube projects <num> cm above the carina, the tube could be advanced by <num>-<num> cm. Otherwise, the appearance of the cardiac silhouette is constant. There are bilateral basal parenchymal opacities of unchanged extent on the left and minimally decreased in extent on the right. No newly appeared parenchymal opacities. No evidence of pneumothorax. No pulmonary edema.
volume overload, questionable malposition of the endotracheal tube.
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Et tube tip lies approximately a <num> cm above the carina, at the level of the lower clavicular heads. Ng tube extends beneath diaphragm, off film. Ij sheath overlies the proximal svc. Swan-ganz catheter noted, likely in the pulmonary outflow tract. No pneumothorax is detected. Cardiomediastinal silhouette is within normal limits for technique. There is upper zone redistribution, without overt chf. Mild elevation of the right hemidiaphragm. No focal infiltrate or effusion. No pneumothorax detected. At the lower edge of these films, an additional tube or drain is partially imaged in right upper abdomen. There are skin <unk> in the upper abdomen. Az lucency in the right upper quadrant could relate to some intra-abdominal free air.
<unk> year old man s/p liver transplant pod#<num> // intubated, eval for interval change in time for sicu rounds <unk>.
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Pa and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is stable with mild enlargement of cardiac silhouette. Imaged osseous structures are intact. Mild compression deformity is noted in the lower thoracic spine as on prior. No free air below the right hemidiaphragm is seen.
<unk>m with sscp
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There is no consolidation, pleural effusion, or pneumothorax. Lungs are mildly hyperinflated. Heart size is top- normal. Mediastinal and hilar and pleural surfaces are unremarkable.
history: <unk>f with chest pain // acute pulmonary process
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Pa and lateral views of the chest were obtained demonstrating sternotomy wires. The lungs are hyperinflated and clear. No focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. There is no free air below the right hemidiaphragm.
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Pa and lateral views of the chest provided. No focal consolidation, large effusion or pneumothorax is seen. There is mild prominence of the hilar markings which likely reflect prominent bronchovascular markings given findings on prior ct, though comparison with a prior chest x-ray would be helpful. Please note, heart size is stable. Mediastinal contour is normal. Bony structures are intact.
<unk>m with palpitations // eval for acute process