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The appearance of the chest is somewhat similar to the prior study with near-complete opacification last the left hemithorax with opacity appearing increased as compared to the prior chest radiographs, and grossly similar compared to scout image from <unk> ct. There is persistent significant leftward shift of the mediastinal structures with subsequent overinflation of the right lung. There is minimal atelectasis/scarring in the right mid lung zone. There is persistent severe compression of a lower thoracic vertebral body in the superior post thoracotomy site postoperative changes are again seen with a prior resection of some of the left-sided ribs.
the left upper lobectomy presenting with shortness of breath and cough.
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Pa and lateral views of the chest provided demonstrate no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm.
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Frontal and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation, or pneumothorax. Hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema. Partially imaged upper abdomen is unremarkable.
pleuritic chest pain. assess for pneumonia.
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As compared to the previous radiograph, there is a newly developed atelectasis in the right middle parts of the lung. Unchanged pre-existing signs of cardiomegaly with minimal fluid overload and potential enlargement of the left pulmonary artery. No pleural effusions. Overall, low lung volumes. No evidence of pneumonia.
increased oxygen requirement, chronic heart failure.
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Upright pa and lateral radiographs of the chest. Right pacer projects over the right lateral chest wall with lead in the right ventricle. Tracheostomy tube is in stable position terminating in the mid thoracic trachea. There has been waxing and waning opacity in the left base since about <unk>. Compared to the next most recent study <num> days ago, the left base is better aerated with some residual opacity and blunting of the costophrenic sulcus. There is chronic streaky atelectasis at the right base. No new focal airspace consolidation is detected. The cardiomediastinal silhouette and hilar contours are stable. There is no pneumothorax.
<unk>-year-old male with trach and shortness of breath. evaluate for pneumonia.
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Frontal and lateral views of the chest were obtained. There is minimal basilar atelectasis. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. No pneumomediastinum is seen.
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Mild cardiomegaly is stable. There has been interval development of small bilateral pleural effusions worse on the left. A pneumothorax is not appreciated. The mediastinal silhouette is unremarkable. There is no pulmonary edema.
<unk> year old man with new hypoxia, eval for pulmonary edema // <unk> year old man with new hypoxia, eval for pulmonary edema
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Left port-a-cath in situ with the tip in the mid to distal svc. No airspace consolidation. No suspicious pulmonary nodules or masses. The cardiomediastinal contour is normal. No pleural effusion. No overt pulmonary hyperinflation. Insufficiency type fractures of the mid to lower thoracic vertebral bodies.
<unk> year old man with increase sob s/p liver transplant. pt has h/o copd. // s?p liver transplant <num> weeks ago now with worsening sob
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The lungs are well expanded and clear. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. No rib fractures are identified.
<unk>-year-old female with syncope. evaluate for acute cardiopulmonary process.
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Frontal and lateral views of the chest. Heart size and cardiomediastinal contours are normal. The lungs are clear without focal consolidation, pleural effusion, or pneumothorax.
wheezing and shortness of breath.
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The lungs are well expanded. There is mild pulmonary vascular congestion, mild reticular opacities, perihilar fullness, and small bilateral pleural effusions, consistent with mild pulmonary edema. Bibasilar opacities are seen, which may reflect atelectasis, although cannot exclude pneumonia or aspiration in the right clinical setting. No pneumothorax is seen. There is mild to moderate cardiomegaly. Left-sided pacemaker is seen with intact leads in appropriate positions.
history: <unk>m with sob for a week // ? reason for shortness of breath
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Ap upright and lateral views of the chest provided.cardiac silhouette is mildly enlarged. The mediastinal contour appears unchanged. There is hilar congestion with moderate pulmonary edema. No large pleural effusions are seen. There is no pneumothorax. Clips are noted in the right axilla. Bony structures are intact. No free air below the right hemidiaphragm.
<unk>f with wheezing, hypotension // eval for pna
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Pa and lateral views of the chest were provided. Tiny clips project over the neck, likely related to prior thyroid surgery. Upper lobe lucency likely reflects underlying emphysema. Mild bibasilar atelectasis is noted without definite signs of pneumonia or effusion. There is no overt edema. Heart size appears grossly stable. Aorta is partially calcified and tortuous. Bony structures appear intact.
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The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. Surgical clips in the right upper quadrant suggest prior cholecystectomy.
<unk>f with asthma history, p/w wheezing and sob after being exposed to indoor chemical cleaning agents. // volume, infiltrate, effusion.
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Comparison is made to previous study from <unk>. There is an enteric tube whose distal tip and side port within the stomach. The heart size is within normal limits. There are low lung volumes due to poor inspiratory effort. No focal consolidation or signs for overt pulmonary edema is identified. Surgical clips are seen about the neck.
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There are bibasilar opacities, right greater than left, increased from the prior study from the day before and raising suspicion for aspiration. However, an overlying infectious process cannot be excluded. Otherwise, the lungs are without a new focal consolidation. Cardiac silhouette appears unchanged. There is no pneumothorax. Osseous structures are grossly unremarkable.
possible pneumonia after cervical spine injury.
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Re- demonstration of the known tracheostomy tube, with tip projecting <num> cm above the carina. Cardiomediastinal and hilar silhouettes are normal. Lungs are clear without focal consolidation, pleural effusion, or pneumothorax.
<unk> year old man with trach, tachycardia, febrile. evaluate for pneumonia.
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The patient is significantly rotated to the left in this study. Within these limitations, there is mild pulmonary vascular congestion without pulmonary edema and moderate to severe cardiomegaly. Lungs are otherwise clear without focal consolidation. A rounded soft tissue density projecting over the heart were may be consistent with a hiatal hernia, or less likely an aortic aneurysm. In addition to thoracolumbar scoliosis, there are marked osteopenic and degenerative changes of the thoracolumbar spine.
<unk> year old woman with new onset afib s/p cervical spine laminectomy for spinal cord meningioma // please eval for any acute cardiopulm process
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A frontal chest radiograph demonstrates interval removal of a left chest tube, now with a tiny apical pneumothorax which is new. The remainder of the exam is unchanged, including small bilateral pleural effusions and bibasilar atelectasis. There is no new focal consolidation. Left rib fractures are again noted. The visualized upper abdomen is unremarkable.
evaluate for pneumothorax after left chest tube removal.
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Heart size is normal. The aorta is mildly tortuous but unchanged. The mediastinal and hilar contours are otherwise unremarkable. Pulmonary vasculature is normal and the lungs are clear. No pleural effusion or focal consolidation is demonstrated. No pneumothorax is identified. There are no acute osseous abnormalities.
cough.
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Pa and lateral views of the chest. No focal consolidation, pleural effusion, or pneumothorax. Cardiomediastinal and hilar contours are normal. On the ap view, there are two vague opacities in the right mid and lower lung measuring approximately <num> cm each, which may represent a confluence of overlapping shadows or may arise from the ribs. Recommend oblique film for further evaluation to rule out a pulmonary nodule. Left axillary surgical clips are noted.
productive cough, fever.
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Cardiac silhouette size is top normal. Mediastinal contours remain unchanged with mild tortuosity of the thoracic aorta again noted. The aorta is diffusely calcified. Hilar contours are normal. Pulmonary vasculature is not engorged. Subsegmental atelectasis versus scarring is again noted within the right middle lobe and lingula, unchanged. No focal consolidation, pleural effusion or pneumothorax is detected. Lungs are hyperinflated with attenuation of pulmonary vascular markings towards the apices compatible with underlying mild emphysema. Remote right-sided rib fractures are visualized. Compression deformity of a mid thoracic vertebral body is unchanged. Mild to moderate multilevel degenerative changes are again seen in the thoracic spine.
history: <unk>f with hemoptysis
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In comparison with the study of <unk>, there again are low lung volumes, which accentuate the size of the cardiac silhouette. Suture drain overlying the upper mediastinum has been removed. No evidence of acute focal pneumonia or vascular congestion.
postoperative tracheal reconstruction.
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The tip of the picc line projects over the superior cavoatrial junction. The tip of the dobhoff feeding tube projects below the level of the diaphragm but beyond the field of view of this radiograph. No focal consolidation or pneumothorax. Chain sutures are present in the left upper lung zone. There is persisting left predominant mediastinal widening as well as a layering left pleural effusion. The size of the cardiac silhouette is within normal limits.
<unk> year old woman with widespread mediastinal lad attributed to tuberculosis (+afb bx by vats <unk>), c/b witnessed generalized tonic-clonic seizure, likely <unk> pres (goal // ? consolidation. pna
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The right ij approach swan-ganz catheter tip ends within the mediastinal contours in the right pulmonary artery, appropriately positioned. Otherwise, no significant interval change. Moderate to severe cardiomegaly persists and is overall unchanged. Mild pulmonary vascular congestion is overall unchanged. No frank pulmonary edema. Lung volumes remain slightly low, overall unchanged. No focal consolidation, pleural effusion, or pneumothorax. The cardiac pacemaker defibrillator device appears intact and unchanged in position.
<unk>-year-old man with cardiogenic shock. evaluate <unk>-<unk> placement.
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Lordotic positioning. Again seen is a right subclavian line, with tip over distal svc. No pneumothorax is detected. There is probable mild cardiomegaly, without significant interval change. There is upper zone redistribution, but no overt chf. Possible minimal retrocardiac atelectasis. Otherwise, no focal infiltrate, consolidation, or gross effusion. Incidental note is made of bilateral cervical ribs. There is pseudoarticulation of the right cervical rib.
<unk> year old man with multiple myeloma // new hypoxia, evaluate for pna
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Ap upright and lateral views of the chest provided. There is airspace consolidation in the right upper lobe, compatible with pneumonia. Elsewhere, the lungs appear clear. Cardiomediastinal silhouette is normal. Bony structures are intact. Hardware partially imaged in the right proximal humerus.
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Comparison is made to previous study from <unk>. The endotracheal tube, right ij central line, right subclavian port-a-cath and left-sided aicd are unchanged in position. There is some improved aeration at the right base. There remains a left retrocardiac opacity. There is mild prominence of pulmonary interstitial markings without overt pulmonary edema. No pneumothoraces are seen on either side.
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Portable semi-upright ap view of the chest was provided. Underpenetrated technique and low lung volumes limit the evaluation. Allowing for this, there is increase in the bilateral pulmonary opacities which could represent pneumonia, multifocal versus atypical pulmonary edema. Please correlate clinically. The heart size cannot be assessed. The mediastinal contour is widened, though this is unchanged. No definite acute bony injury.
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The lungs are well expanded and clear. Hila and cardiomediastinal contours and pleural surfaces are normal.
<unk> year old woman with asthma, fever, cough // r/o pna
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The cardiac silhouette size remains top normal. The mediastinal and hilar contours are stable, and within normal limits. Lungs are clear. No pleural effusion or pneumothorax is present. There is no evidence for pulmonary edema. No acute osseous abnormalities are seen. Clips are noted within the neck compatible with prior thyroidectomy.
status post thyroidectomy with chest pain for <num> week.
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As compared to the previous radiograph, there is no relevant change. Known right basal lung collapse. Small right pleural effusion. Small left pleural effusion. Moderate cardiomegaly. In the well ventilated areas of the lung, there is no evidence of pneumonia. The sternal wires show unchanged alignment.
questionable lung collapse.
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Lung volumes are similar when compared to the prior study. The cardiomediastinal contour is within normal limits allowing for the projection. The heart is not enlarged. Mild prominence of the pulmonary interstitial markings may reflect a mild degree of pulmonary edema. No consolidation, pneumothorax or pleural effusion seen.
<unk> year old woman with severe asthma/copd in micu for respiratory failure // eval for interval change
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Pa and lateral chest radiograph demonstrates clear lungs bilaterally. There is no focal consolidation convincing for pneumonia. Cardiomediastinal and hilar contours are within normal limits. There is no evidence of pulmonary edema, pneumothorax, or pleural effusion. Imaged osseous structures and upper abdomen are without an acute abnormality.
<unk>-year-old male with cough for <num> week. evaluate for pneumonia.
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There is increased central vascular congestion with likely mild interstitial pulmonary edema. There is no focal consolidation, effusion or pneumothorax. Mediastinal and hilar contours are normal. Mild cardiomegaly is unchanged.
<unk>m with increasing edema, decreasing uop, recent renal xplant
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Portable supine radiograph of the chest demonstrates an endotracheal tube terminating approximately <num> cm above the carina. A transesophageal tube is incompletely imaged. Cardiomediastinal contours are or widened, without change since recent study of less than <num> hr earlier. Median sternotomy wires are well aligned and intact. Interval worsening of left lower lobe atelectasis and small left pleural effusion. Minor atelectasis at right lung base is new. .
history: <unk>m with intubated head bleed //
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Ap upright chest radiograph demonstrates hyperexpanded lungs. Nipple shadows project over the lung bases bilaterally. Moderate cardiomegaly is stable relative to prior examination dated <unk>. There is no evidence of pulmonary edema. No large pleural effusion or pneumothorax is identified. No focal consolidation convincing for an infectious process is identified. There is no air under the right hemidiaphragm.
<unk>f with cp // eval for ptx
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Cardiomediastinal silhouette and hilar contours are stable. An endotracheal tube is in appropriate position with the tip terminating <num> cm cranial to the carina. A right subclavian approach central venous catheter is in place with the tip terminating at the cavoatrial junction. Moderate-to-severe pulmonary edema is unchanged with moderate bilateral pleural effusions. A persistent focus of asymmetric density in the right upper lung is slightly worse compared to <unk>.
cirrhosis with posterior fossa hemorrhage status post posterior decompression.
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Heart size is normal. Cardiomediastinal silhouette and hilar contours are unremarkable. Lung volumes are low but are otherwise clear. There is no pleural effusion or pneumothorax. No free air seen below the diaphragm.
fevers and vomiting.
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As compared to the previous radiograph, the position of the monitoring and support devices is constant. There is an increase in extent and severity of the pre-existing left parenchymal opacities, notably in the region of the left lung apex. The right lung, including the chest tube position, is constant. Constant size of the cardiac silhouette. As on the previous radiograph, the presence of a small left pleural effusion cannot be excluded.
followup.
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The cardiomediastinal contours are within normal limits. The bilateral hila are unremarkable. The lungs are clear without focal consolidation. There is no evidence of pulmonary vascular congestion. There is no pneumothorax or pleural effusion.
<unk>f with whol, paresthesias, evaluate for pneumonia.
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Haziness over the mid to lower lung fields is felt to be due to overlying soft tissues without definite focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen.
history: <unk>f with r chest wall pain after fall // r/o fx
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As compared to the previous radiograph, the neoesophagus is slightly better visible. There is no evidence of pneumothorax or pneumomediastinum after dilatation procedure. No focal parenchymal opacities suggesting pneumonia. No pleural effusions. Normal size of the cardiac silhouette, mild tortuosity of the thoracic aorta.
status post esophagectomy three months ago, evaluation for pneumothorax after intervention.
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The patient is status post recent median sternotomy and coronary bypass surgery and mitral valve replacement. Cardiomediastinal contours are within normal limits for postoperative status of the patient. Interval improvement in extent of bibasilar atelectasis. Bilateral small to moderate pleural effusions also appears slightly improved. No visible pneumothorax.
<unk> year old woman s/p cabg/mvr // eval effusions
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Right sided hemodialysis catheter, left ij line are unchanged in position. Ventriculoperitoneal shunt projects over the right hemi thorax. There are persistent unchanged bilateral pleural effusions and cardiomegaly. Mild pulmonary edema persists.
<unk> year old woman with hypoxia // acute process
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Since <unk>, no appreciable change in the bilateral heterogeneous juxta-mediastinal and peripheral pulmonary parenchymal opacities. Stable appearance of the cardiomediastinal silhouette and hila. Stable bilateral lower lung volumes and slight elevation of the right hemidiaphragm. Stable slightly tortuous or new dilated descending aorta.
<unk>-year-old man with stage iiib nsclc, status-post chemoradiation in <unk>, with radiation pneumonitis. evaluate for interval change.
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The cardiac, mediastinal and hilar contours appear unchanged. The heart is again at the upper limits of normal size. Lung volumes are low. The lungs appear clear. There are no pleural effusions or pneumothorax. Anterior flowing osteophytes are noted along the mid to lower thoracic spine.
chest pain.
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The lungs are normally expanded and clear. There is no focal airspace opacity to suggest pneumonia. Mediastinal wires are intact projecting over the upper chest and partially visualized spinal fixation hardware is seen projecting over the neck. The cardiomediastinal silhouette and hilar contours are normal. The aorta is somewhat unfolded. There is no pleural effusion or pneumothorax.
fever, cough. rule out aspiration.
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In comparison with the study of <unk>, the swan-ganz catheter has been removed and a right jugular catheter remains in place. Continued enlargement of the cardiac silhouette without appreciable pulmonary vascular congestion. Dual-channel pacer-defibrillator is again seen with the leads terminating in the right atrium and apex of the right ventricle. There is some increased opacification at the left base consistent with worsening pleural effusion and substantial volume loss in the left lower lobe. The right lung is essentially clear.
to assess for effusions.
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The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified.
<unk>f with altered mental status // eval for acute process
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Ap upright and lateral views of the chest are provided. Subtle retrocardiac opacity is seen best on the lateral projection which could represent a lower lobe pneumonia, likely right-sided. Aside from this, the lungs appear clear. The cardiomediastinal silhouette is stable. Bony structures are intact. A calcified density is again seen projecting over the left shoulder in a somewhat different position, suggesting mobility.
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There has been interval placement of a left axillary single-lead icd defibrillator with lead terminating in the right ventricle as expected. There is no pneumothorax or pleural effusion. The cardiomediastinal and hilar contours are normal. There is no focal consolidation concerning for pneumonia. Pulmonary vasculature is within normal limits.
icd placement.
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A dual lead pacemaker/icd device appears similar with leads again terminating in the right atrium and ventricle, respectively. The cardiac, mediastinal and hilar contours appear unchanged including mild cardiomegaly. There is similar relative elevation of the left diaphragm with associated streaky opacification suggesting minor atelectasis. There is no pleural effusion or pneumothorax. The bones appear demineralized. Mild degenerative changes are noted throughout the thoracic spine. There is similar moderate rightward convex curvature centered along the mid thoracic spine.
recurrent paroxysmal atrial fibrillation.
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Tip of endotracheal tube terminates <num> cm above the carina. Nasogastric tube and central venous catheter remain in standard position. Heart size is normal, and lungs are grossly clear except for minimal patchy opacity at the left base, most likely due to patchy atelectasis.
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Pa and lateral views of the chest provided. Lung volumes are low which somewhat limit the evaluation. Allowing for this, there is no focal consolidation, large effusion or pneumothorax. No signs of congestion or edema. Heart and mediastinal contours are normal. Bony structures are intact. No free air below the right hemidiaphragm.
<unk>m with dyspnea and palpitations
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Single frontal view of the chest demonstrates stable cardiomegaly. New consolidation in the upper lobes and right lower lobe is most likely pneumonia. There is also retrocardiac opacity which could represent dependent atelectasis versus additional site of consolidation. Trace effusions cannot be excluded. There is no pneumothorax or vascular congestion.
<unk>-year-old female with history of congestive heart failure. question pneumonia.
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The heart is normal in size. Patchy calcification is noted along the aortic arch and there is similar mild aortic unfolding. The mediastinal and hilar contours appear unchanged. There is no pleural effusion or pneumothorax. Surgical clips project along the base of the left neck. The lungs appear clear. Mild degenerative changes are similar along the thoracic spine. A few surgical clips are also seen on the right side. There has been no significant change.
new onset of atrial fibrillation.
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The lungs are well expanded and clear. Right lower lobe opacity seen on previous ct is not well visualized on this radiograph. The pleural surfaces are normal without pleural effusion or pneumothorax. Mildly enlarged heart size and mild hilar prominence are unchanged from prior. Mediastinal contour is normal. Limited assessment of osseous structures are unremarkable.
cough, history of sickle cell. assess for pneumonia.
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As compared to the previous radiograph, there is a newly appeared right upper lobe opacity with subtle air bronchograms. In light of the clinical presentation, pneumonia is to be suspected. Scars at the left lung bases and a small left pleural effusion are also present. Otherwise, the radiograph is unchanged. At the time of dictation and observation, <time> p.m., on <unk>, the referring physician <unk>. <unk> was paged for notification and the findings were discussed.
history of seizure and frequent aspiration, now fever. evaluation.
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Low lung volumes are present. A right perihilar opacity appears to have increased in size compared to the prior study, likely reflecting the patient's known lung malignancy. There are ill-defined bibasilar somewhat consolidative opacities, new in the interval. Elevation of the right hemidiaphragm is chronic. There is a small right pleural effusion, and likely a trace left pleural effusion. No pneumothorax is identified. There is crowding of the bronchovascular structures but no frank pulmonary edema is identified. Evaluation the heart size is difficult given the presence of bibasilar airspace opacities. No acute osseous abnormality is visualized.
known pneumonia and possible sepsis. history of metastatic lung cancer.
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Interval placement of right internal jugular catheter with tip terminating in the proximal superior vena cava and no visible pneumothorax. Other indwelling devices are in standard position. Heart is upper limits of normal in size, and is accompanied by pulmonary vascular congestion and improving pulmonary edema pattern. A more confluent area of airspace consolidation persists in the left upper lobe, and is concerning for infectious pneumonia in the appropriate clinical setting. Followup radiographs after appropriate therapy are suggested to ensure resolution and to exclude a neoplasm in this region.
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There are low lung volumes. There is a hazy opacity at the right lung base which may represent atelectasis but an infectious process cannot be excluded. Cardiomediastinal silhouette is slightly enlarged, similar to prior exam. There is no pneumothorax or pleural effusion.
tachycardia.
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The lungs are clear. There is no effusion or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormalities identified.
<unk>m with cp // eval for pna, ptx, cardiomeg
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As compared to the previous radiograph, no relevant change is noted. No pneumothorax after pacemaker insertion. One lead is in the right atrium and the second in the right ventricle. The leads are intact. No pleural effusions. No pulmonary edema.
pacer placement.
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Pa and lateral views of the chest were provided. Airspace consolidation is noted within the right middle lobe. There is no pleural effusion or pneumothorax. Cardiomediastinal silhouette is stable. There is no free air beneath the right hemidiaphragm.
<unk>f with <num> day hx of cough, eval for consolidation
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Cardiac silhouette is enlarged but stable in size. Pulmonary vascularity is normal. Slight worsening of bibasilar atelectasis, which remains more prominent in the left lower lobe than the right. Persistent small right and small-to-moderate left pleural effusions.
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Lung volumes are somewhat low which accentuates bronchovascular markings. The cardiomediastinal and hilar contours are within normal limits. The aorta is minimally calcified. Subtle bibasilar opacities suggest atelectasis however infection should be considered in the appropriate clinical setting. There is no pleural effusion or pneumothorax identified. The stomach is moderately distended with gas and fluid.
<unk>m w/weakness // <unk>m w/weakness
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Frontal and lateral views of the chest were obtained. As on the prior study, there is continued pulmonary vascular congestion. Slight increased opacity at the lung bases may relate to fluid overload although underlying consolidation is not excluded in the appropriate clinical setting. No pleural effusion or pneumothorax is seen. The cardiac silhouette remains mildly enlarged. The aorta is calcified and tortuous. Degenerative changes are again seen along the spine.
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Pa and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding similar study of <unk>. Heart size is difficult to assess because of overlying left-sided pulmonary abnormalities. Heart size is probably normal as there is no evidence of pulmonary vascular congestion. Multiple previous chest examinations are reviewed in sequence, demonstrating that the fibrotic changes have progressed continuously since <unk>. Comparison with the next preceding chest examination of <unk> demonstrates further progress to a lesser degree. Again, there are bilateral, mostly basal linear changes, most marked on the left side where there also blend with the mediastinal structures and obscure the cardiac contours. On the left base laterally, in the vicinity of the chest wall, there are increased local densities identified, which are suggestive of possibly new acute processes. The diagnosis is not conclusive in light of the previously existing rather advanced changes. It is therefore suggested to treat the patient for the present acute infection and take a followup chest examination with shorter time interval (one week) to see if these changes are regressing.
<unk>-year-old female patient with idiopathic pulmonary fibrosis, cough, and fever. evaluate for possible new pneumonia.
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Comparison is made to prior study from <unk>. Heart size is upper limits of normal. There is a small pleural effusion on the right side. There is no focal consolidation, pneumothoraces or overt pulmonary edema. Minimal subsegmental atelectasis at the lung bases is present. There has been improved aeration at the left retrocardiac area since the prior study.
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Pa and lateral chest radiograph is compared to prior radiograph dated <unk>. The appearance of the thorax is not significantly changed. No focal opacity convincing for pneumonia is identified. Cardiomediastinal and hilar contours remain within normal limits. Patchy opacities within the left upper lobe and lingula are thought to reflect radiation changes. There is no pleural effusion or pneumothorax. Visualized osseous structures are without an acute abnormality.
<unk>-year-old female with history of renal transplant presents with cough and fever.
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Interval decrease in lung volumes with new mild bibasilar atelectasis. Increased retrocardiac opacity from atelectasis and possibly new evolving pneumonia. New small bilateral pleural effusions with mild vascular engorgement from mild interstitial edema. Mildly enlarged heart size is accentuated by lung volumes. Normal mediastinal and hilar contour. Stable moderate sized hiatal hernia.
<unk>-year-old male with recent sepsis. assess for focal pneumonia.
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There has been interval placement of a left pectoral pacemaker with dual leads terminating in the right atrium and right ventricle. The course of the leads is unremarkable and there is no pneumothorax. The inspiratory lung volumes are appropriate. The hazy left basilar opacity corresponds to a large fat containing diaphragmatic hernia. There is no focal consolidation or pleural effusion. The pulmonary vasculature is not engorged. The cardiomediastinal and hilar contours are within normal limits. No acute osseous abnormality is detected.
<unk> year old man with sss s/p dual chamber pm. // rule out pneumothorax
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Frontal and lateral views of the chest. The lungs are clear without focal consolidation, effusion, or pulmonary vascular congestion. The cardiac silhouette are unchanged. No acute osseous abnormality is identified, hypertrophic changes seen in the spine.
<unk>-year-old male with left-sided chest pain.
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As compared to the previous radiograph, there is unchanged evidence of bilateral basal areas of atelectasis. In addition to that, there is currently no evidence of other parenchymal abnormalities, in particular no evidence of pneumonia or pulmonary edema. No lung nodules or masses. Borderline size of the cardiac silhouette with tortuosity of the thoracic aorta.
chest pain, hypotension, evaluation.
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There are bilateral calcified pleural plaques with some regions projecting over the hemidiaphragms bilaterally as well as overlying the midlung bilaterally. These plaques somewhat obscure the underlying lung parenchyma although there is no large confluent consolidation. There is no effusion or edema. The cardiomediastinal silhouette is within normal limits for technique. No acute osseous abnormalities.
<unk>m with daily alcohol use, altered mental status // eval for chf/pneumonia, intracranial hemorrhage, cspine fracture
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The patient is status post median sternotomy and cabg. The cardiomediastinal and hilar contours are stable. Slightly increased opacity at the base of the left lung may represent atelectasis or scarring, but is stable from the prior exam. No pleural effusion or pneumothorax.
history: <unk>m with near syncope today // eval for consolidation
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The stomach is markedly distended. The visualized portions of transverse colon measure up to <num> cm with stool. The lungs are clear without infiltrate or effusion.
cerebral palsy, cough and fever.
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A subtle <num> cm diameter rounded cystic lesion is present in the left infrahilar region, corresponding to a focal abnormality in the superior segment left lower lobe detected on recent ct thoracic spine study of one day earlier. Lungs are otherwise clear except for a small calcified granuloma in the left lower lobe. There are no pleural effusions or acute skeletal findings.
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A right-sided port ends in appropriate position. Tracheostomy and thoracic and abdominal aortic stents are again seen and unchanged. Again seen are bilateral diffuse parenchymal opacities that appear similar to <unk>. There may be tiny bilateral pleural effusions. No pneumothorax.
fever and tachycardia. evaluate heart and lungs.
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The patient is status post median sternotomy with intact wires. Clips are seen within the mediastinum. The lungs do not demonstrate focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is stable. The bony structures are grossly intact.
fall, question acute cardiopulmonary process, fracture or dislocation.
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In comparison with radiographs from <unk>, allowing for differences in technique, there has been interval removal of bilateral bronchial stents. There is no pneumothorax or pneumomediastinum. Lung volumes are low, accentuating the cardiac silhouette and resulting in crowding of the bronchovascular structures. There is no focal consolidation, effusion or pulmonary edema. Mediastinal and hilar contours are unchanged. Heart size is normal.
<unk> year old woman s/p bronchial stent removal // t/o pneumothorax
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Ap single view of the chest has been obtained with patient in sitting semi-upright position. The heart size is within normal limits. Moderate widening and elongation of thoracic aorta, but no local contour abnormalities are identified. The pulmonary vasculature is not congested. No signs of acute parenchymal infiltrates are present and the lateral pleural sinuses are free. Moderate elevation of the left hemidiaphragm coincides with gas-distended left-sided colonic loops. No evidence of pneumothorax in the apical area. No indwelling lines or tubes. Our records do not include a previous chest examination available for comparison.
<unk>-year-old female patient with fever and desaturation, evaluate for pneumonia.
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Eventration of the right hemidiaphragm is unchanged. Chronic changes centered at the lung bases are as previously noted compatible fibrosis. There is no new consolidation. Cardiomediastinal silhouette is stable. No acute osseous abnormalities.
<unk>m with bilateral crackles. no history of chf. recent dx of pneumonia // r/o pneumonia, chf
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The lungs are well inflated and clear. There is no pleural effusion. There is cardiomegaly as before. Unfolding of the thoracic aorta is present. Diffuse demineralization and bilateral acromioclavicular arthropathy noted. Multilevel degenerative changes of the thoracic spine are present. The right-sided picc is no longer present at the cavoatrial junction and appears to have shifted proximally with tip terminating, likely in the right subclavian vein.
<unk> yo f with h/o ovarian cancer and on prednisone <num> days of cough // assess for pna
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There is a large left-sided pleural effusion with associated atelectasis. The right lung remains clear. Cardiac silhouette cannot be accurately assessed. No acute osseous abnormalities.
<unk>f with pleural effusion at osh pls eval interval change // history: <unk>f with pleural effusion at osh pls eval interval change
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Ap single view of the chest has been obtained with patient in semi-upright position. Patient is status post upper lobe wedge resection. There is mild elevation of the left hemidiaphragm. A left-sided chest tube has been placed, seen to terminate in the left apical area. Linear densities reaching from the hilum up to the axillary region are indicative of the recent chest intervention. No significant pneumothorax is identified in the apical area. No mediastinal shift. The right hemithorax demonstrates normal pulmonary vasculature without evidence of congestion.
status post left upper lobe wedge resection. check ct placement and evaluate for pneumothorax.
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There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is unchanged with tortuous aorta, hiatal hernia and mild cardiomegaly. Linear opacity in the right lung base is similar to the remote prior study and likely represents atelectasis or scarring. . Blunting of the left posterior costophrenic sulcus likely represents a bochdalek's hernia. Multiple chronic appearing rib fractures are unchanged from the prior study. Hyperinflation suggests copd.
<unk>m with altered mental status, slurred speech evaluate for pneumonia or bleed.
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Portable semi-upright radiograph of the chest demonstrates initial placement of the endotracheal tube into the right mainstem bronchus. The endotracheal tube was subsequently repositioned such that the tip ends <num> cm from the carina. There has been interval clearing of the right base, and new obliteration of the left hemi-diaphragm, consistent with pleural effusion and atelectasis. Probably tiny left apical pneumothorax is stable.
<unk> year old woman with sepsis and hypoxia, now intubated // please evaluate position of ett
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The lungs are clear. There is no evidence of pneumonia, pneumothorax, or pleural effusion. Cardiac silhouette is normal in size.
history: <unk>f with retrosternal chest pressure // evaluate for acute process
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Heart size remains mild to moderately enlarged. The aorta is unfolded and diffusely calcified. There is mild pulmonary edema, new in the interval. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities seen.
history: <unk>f with chf with worsening sob // eval edema, effusion
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Again, there is chronic elevation of the left hemidiaphragm with basilar atelectasis. Bibasilar atelectasis is seen. No large pleural effusion is seen. There is no definite new focal consolidation. Cardiac and mediastinal silhouettes are grossly stable.
history: <unk>m with c/o sob and hx cauda equina secondary to l<num> herniated dsic, copd, bronchiectasis with emphysema // ? pna
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The heart is at the upper limits of normal size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The bony structures are unremarkable.
fever, sore throat, sputum production.
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There is mild bibasilar atelectasis without definite focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable.
history: <unk>f with sob // r/o infectious process
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Ap upright and lateral views of the chest were provided. The lungs are clear. The heart is mildly enlarged, though stable. The mediastinal contour is unremarkable aside from a slightly unfolded thoracic aorta. There is no pneumothorax or pleural effusion. The imaged bony structures appear intact. There is mild degenerative disc disease in the mid thoracic spine. No definite compression fracture or rib fracture is seen.
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Mild cardiomegaly has worsened. The mediastinal and hilar contours are normal. Upper lung zone vascular redistribution and interstitial edema are consistent with fluid overload. No focal consolidation, pleural effusion, or pneumothorax.
<unk> year old woman with etoh cirrhosis c/b hepatic encephalopathy // ? pneumonia or infiltrate
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The lungs are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.
<unk>f with sob // eval for any infiltrates
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As compared to the previous radiograph, there could be a minimal increase in extent of the pre-existing bilateral pleural effusions. There are extensive areas of atelectasis. The size of the cardiac silhouette can no longer be exactly be limited. The monitoring and support devices are unchanged. No pneumothorax. Unchanged displaced rib fractures.
fall, status post pneumothorax.
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As compared to previous radiograph, there is a newly appeared zone of parenchymal opacities in the retrocardiac lung areas. The opacities are predominantly peribronchial and could reflect non-recent infection. Otherwise the radiograph is unchanged. There is no evidence of other infectious foci. No pleural effusions. No parenchymal opacities suggesting malignancy. Unchanged normal size of the cardiac silhouette. Minimal tortuosity of the thoracic aorta. Dr. <unk> was paged for notification at the time of dictation, <time> a.m., on <unk>.
history of copd, one month of cough, rule out 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.
history: <unk>f with ongoing dry cough // reason for patient's cough?