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Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear except for a linear focus of scar or atelectasis in the retrocardiac region. Pectus deformity results in hazy increased opacity adjacent to the right heart border on the frontal radiograph. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.
<unk> year old woman with with ongoing cough, congestion and fever x <num> weeks // ? pna
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Cardiac, mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vascularity is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.
shortness of breath.
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The lung volumes are unchanged. The right lung is clear. The cardiomediastinal and hilar contours are unchanged. Any residual left apical pneumothorax is extremely small. A loculated left pleural effusion is substantial is slightly worsened. The right pleural surfaces are normal. The osseous structures are stable.
<unk> year old woman with lll effusion - loculated, failed chest tube placement // ?ptx
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The lungs are well expanded and clear without focal consolidation, pleural effusion or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal. No acute osseous abnormality is identified. There is no free air under the diaphragm. A healed left posterior sixth rib fracture is noted.
<unk>-year-old woman with cough and mild shortness of breath with moderate left shoulder and arm pain.
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Ap portable upright view of the chest. Cardiomegaly is again seen. Areas of scarring along the right lung base again seen. There is no focal consolidation concerning for pneumonia. No edema, congestion or pneumothorax. Mediastinal contour stable. Bony structures are intact. No free air below the right hemidiaphragm.
<unk>f with bradycardia // eval for bradycardia
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The endotracheal tube is at least <num> to <num> cm above the carina. Small left pleural effusion effusion is present. No evidence of pneumothorax. There is mild pulmonary vascular congestion and mild asymmetric edema unchanged compared to prior study. Chronic left lower lobe collapse is also noted. The monitoring and support devices are unchanged compared to prior study.
<unk> year old man s/p lvad/open chest/avr // eval for collapse/infiltrates in patient with elevated wbc
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Left-sided dual-lumen central venous catheter tip terminates within the right atrium, unchanged. Cardiac, mediastinal and hilar contours are within normal limits, and the heart size is normal. Lungs are clear and remain hyperinflated. No focal consolidation or pneumothorax is present. Minimal blunting of the left posterior costophrenic sulcus on the lateral view may suggest a trace left pleural effusion. There is no pulmonary vascular engorgement. Multiple clips are demonstrated within the right upper quadrant of the abdomen.
cough, shortness of breath.
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The lungs are well aerated and clear. Heart size and mediastinal contours are normal. There is no pleural effusion or pneumothorax. Osseous structures are intact. Right picc is seen with tip over the mid to lower svc. Hardware seen in the right humeral head.
<unk>f with right flank pain, fever s/p left mtp washout currently on vanc/ctx // ?pna with r back pain and recent hospitalization. also picc position
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Left lung base subsegmental atelectasis is present. The lungs are otherwise clear. There is no pneumothorax. The heart and mediastinum are within normal limits despite the projection. Multiple metallic surgical clips are present in the right axilla.
<unk> year old woman with cad, ckd s/p precath hydration now sob; evaluate for pulmonary edema
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The lungs are low in volume with congested pulmonary vasculature and thickened septal lines which reflect mild pulmonary edema. The heart is mildly enlarged with normal cardiomediastinal silhouette. There is no pleural effusion or pneumothorax.
hip fracture and hypoxia, assess for intrathoracic process.
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Comparison is made to prior study from <unk>. A swan-ganz catheter has been pulled back slightly and is still overlying the pulmonary outflow tract. There is unchanged position of the support lines. New mediastinal clips are seen. Pneumomediastinum is unchanged and consistent with the recent surgery. Mediastinal contour is also stable. There is some mild pulmonary vascular congestion and stable pleural effusions bilaterally, left greater than right. No pneumothoraces are identified.
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Two views were obtained of the chest. The lungs are well expanded and clear without pleural effusion or pneumothorax. The heart is normal in size with normal mediastinal contours. No displaced rib fractures are identified. Right humeral postsurgical changes are better seen on the dedicated shoulder radiographs.
fall, assess for pneumothorax.
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Hardware seen in the left clavicle. Chest tube has been removed. There are multiple left rib fractures again seen. Atelectasis in lungs bilaterally is unchanged. No pneumothorax. No pleural effusion. Cardiomediastinal and hilar contours are normal.
left rib fractures, status post chest tube, evaluate for pneumothorax.
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Pa and lateral views of the chest provided. Lungs are hyperinflated compatible with copd. 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.
history: <unk>f with ams, abnormal cerebellar exam. // pneumonia?
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Low lung volumes show no focal opacity, pleural effusion, pulmonary edema or pneumothorax. Left apical linear markings are likely secondary to scarring/chronic atelectasis. The cardiac and mediastinal contours are normal.
history of asthma presents with chest tightness. evaluate for intrapulmonary process.
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A picc line terminates at the right lower superior vena cava. The heart is probably enlarged to a mild degree. There is marked unfolding of the aorta and the arch may be dilated. Flattening of the right costophrenic sulcus suggests potentially an effusion versus pleural thickening or scarring, but the lungs appear clear. Left-sided rib deformities appear very likely chronic, with a remodeled appearance, and probably related to remote prior trauma.
respiratory distress.
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Pa and lateral views of the chest provided. Port-a-cath is unchanged with tip extending to the mid svc region. Left atrial ligation clip appears unchanged. The heart remains moderately enlarged. There is mild pulmonary edema noted. Small bilateral pleural effusions are present. No pneumothorax. Mediastinal contour is stable. An azygous fissure is noted. Bony structures are intact. Clips in the left upper quadrant are noted.
<unk>f with positive blood cultures // r/o pna
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In comparison with the study of <unk>, there is little interval change. Again there are bilateral pleural effusions, more prominent on the right, with underlying atelectatic changes. In the appropriate clinical setting, supervening pneumonia would have to be considered. No evidence of pulmonary vascular congestion.
cirrhosis and hepatocellular carcinoma with shortness of breath after stopping diuretics.
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The cardiomediastinal silhouette is stable with mild enlargement of the cardiac silhouette and tortuosity of the aorta. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. There is stable mild prominence of the central pulmonary vasculature without overt pulmonary edema.
elevated blood pressure, headache, blurry vision.
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The cardiomediastinal contours and hilar contours are stable. There is no pleural effusion or pneumothorax. Left basilar opacity is worsened on the current study. Again seen is a rounded calcific density overlying the posterior third rib, likely a bone island. Et tube has been withdrawn, now terminating approximately <num> cm above the carina. Enteric tube is present with tip in the stomach pointing towards the pylorus.
meningitis, assess for interval change.
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Lung volumes are low, causing bronchovascular crowding. However, there is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits.
<unk>-year-old man with tachycardia. no leukocytosis. evaluate for pneumonia.
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Interval placement of right-sided chest tube which appears to terminate deep, medial in the right chest projecting over the mediastinum. Interval placement of an enteric tube which courses below the level the diaphragm, inferior aspect not included on the image. Endotracheal tube terminates approximately <num> cm above the level of the carina. Opacity projecting over the left upper to mid lung worrisome for pulmonary contusion with possible small left pleural effusion. Again seen extensive subcutaneous emphysema, bilateral rib fractures, right clavicle fracture. Scapular and sternal fracture betters seen on ct.
history: <unk>m with r new chest tube*** warning *** multiple patients with same last name! // chest tube placement"?
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As compared to the previous radiograph, there is improvement of the pre-existing right pleural effusion. On the left, the presence of a minimal pleural effusion cannot be excluded. The lung volumes remain low, with atelectatic changes at the right lung bases in the retrocardiac lung areas. Moderate cardiomegaly, unchanged monitoring and support devices, unchanged abdominal drains and post-surgical clips.
status post liver transplant, evaluation for pneumonia and pleural effusion.
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Ap portable upright view of the chest. Left chest wall pacer device is unchanged in position with leads extending to the region of the right atrium and right ventricle as well as the coronary sinus. The heart remains moderately enlarged. Subtle opacity is seen within the left mid lung which could represent an early developing pneumonia. Alternatively, asymmetric pulmonary edema is difficult to exclude in the correct clinical setting. Mild pulmonary vascular congestion is present. No large effusion or pneumothorax. Bony structures are intact. Subtle deformity of the right humeral neck likely reflect an old injury.
<unk>f with sob // ?pulm edema
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Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Blunting of the left posterior costophrenic angle is stable as compared to the prior study. The cardiac and mediastinal silhouettes are also stable. No displaced fracture is seen.
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Endotracheal tube terminates approximately <num> cm above the carina. Lung volumes remain low. Confluent lung opacities on the right side have worsened with indistinctness of right hemidiaphragm margins. Suggestive of asymmetric worsening of moderately sever pulmonary edema. Mild-to-moderate pleural effusion on the right side is new. Left internal jugular line ends at mid svc. Cardiomediastinal silhouette is stable in appearance.
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Exam is technically limited due to flexed position of the head and neck resulting in obscuration of the left apex and superior mediastinum. Additionally, marked rotation of the patient also accentuate mediastinal structures. Widening of upper mediastinum appears to be due to mediastinal lipomatosis as evident on ct torso of <unk>. Heart size is normal, and pulmonary vascularity is normal. Lungs are clear except for linear opacities at the lung bases, which may reflect atelectasis and/or scarring.
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A single portable ap chest radiograph was obtained. The exam is limited by ap technique and poor penetration. The tip of a right internal jugular catheter is near the confluence of the internal jugular and brachiocephalic veins. Mediastinal drains are incompletely visualized. Median sternotomy wires are intact. There is increased aeration of the right upper lobe. The right minor fissure remains minimally elevated suggesting persistent right upper lobe volume loss. There is a small amount of edema and/or atelectasis in the right minor fissure. Moderate atelectasis and effusion are present at the left base. Post-operative mediastinal widening is improving. No focal consolidation or pneumothorax is present.
<unk>-year-old man status post cardiac surgery with right upper lobe collapse.
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In comparison with the study of <unk>, there is hazy opacification posteriorly consistent with pleural fluid. Mild elevation of the right hemidiaphragmatic contour persists. There is patchy opacification at the bases, more prominent on the left, concerning for pneumonia. No evidence of pulmonary edema.
widely metastatic malignancy with unknown primary, concern for pneumonia.
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The lungs are clear without focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities, degenerative changes noted at the shoulders.
<unk>f with fevers/cough // pna
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As compared to the previous radiograph, the appearance of the bibasilar consolidations, right more than left, are comparable to the previous exam. Slightly increased lung density in the region of the right lung apex is also unchanged and could represent mild pulmonary edema. Finally, an area of left lateral pleural thickening is also constant. Unchanged size of the cardiac silhouette. Unchanged low lung volumes, unchanged left-sided drain.
metastatic renal cancer, hemoptysis, evaluation.
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As compared to the previous radiograph, the two right chest tubes are unchanged and in constant position. The pleural fluid collection on the right is also constant. No change in appearance of the left lung and of the cardiac silhouette. No change in appearance of the paramediastinal right-sided increasing perihilar soft tissue density. No pneumothorax.
pleurx catheter placement.
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The lungs are hyperinflated. A right lower lobe airspace opacity has improved. A small right pleural effusion is unchanged. Lower lobe bronchiectasis is better seen on the <unk> chest ct. There is no pneumothorax. Mild cardiomegaly is unchanged. An ivc filter is partially imaged.
<unk> year old woman with chronic aspiration and recurrent pna. // f/u of right sided infiltrate and effusion
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Ap and lateral radiographs of the chest demonstrate the lungs are well expanded and clear. The cardiomediastinal silhouette is unremarkable. There is no evidence of pulmonary edema, pleural effusion, pneumothorax or focal consolidation concerning for pneumonia. Coronary artery stents are noted.
<unk>-year-old female with fevers and diarrhea. evaluation for pneumonia.
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A left pectoral pacemaker is unchanged in position with two leads terminating in the right atrium and right ventricle. The patient is status post median sternotomy with intact appearing wires. Multiple mediastinal surgical clips are compatible with prior cabg surgery. The cardiomediastinal silhouette remains prominent but stable in comparison to the prior study. The inspiratory lung volumes are persistently low with mild bibasilar atelectasis. Mild pulmonary vascular congestion is unchanged. No focal consolidation concerning for pneumonia, pleural effusion, or pneumothorax is detected. No acute osseous abnormality is identified.
syncope and chest pain, here to evaluate for pneumonia.
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Nodular opacities in the right middle lobe and lingula have slightly increased when compared to <unk>. There is also a cluster of calcified nodules in the right upper lobe which have also slightly increased. The cardiopericardial silhouette is slightly increased. No pneumothorax or pleural effusions. Multiple healing rib fractures on the left posteriorly.
<unk> year old woman with recurrent sinusitis, cll, hypogammaglobulinemia and persistent cough. // evidence of pneumonia
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The cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is no focal lung consolidation. Mild peribronchial thickening is most pronounced in the right middle lobe. There is no acute osseous abnormality.
<unk>f with graves disease, on methimazole, now left chest pain, evaluate for pneumonia..
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Left-sided dual chamber pacemaker device is noted with leads terminating in the right atrium and ventricle. Moderate enlargement of the cardiac silhouette is re- demonstrated, a component which may reflect a pericardial effusion. The mediastinal and hilar contours are similar. Pulmonary vasculature is not engorged. There is a continued moderate right pleural effusion, with trace left pleural effusion, not substantially changed in the interval. No pneumothorax is seen. Mild atelectasis is noted in lung bases. There are mild degenerative changes noted in the thoracic spine with slight loss of height of a vertebral body at the thoracolumbar junction, unchanged.
history: <unk>f with dyspnea and history of chf
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Moderate cardiomegaly appears slightly increased when compared to the prior exam. The aorta remains tortuous, with atherosclerotic calcification again demonstrated at the aortic arch. Mild pulmonary edema is new compared to the prior exam. Small bilateral pleural effusions are also new. Evaluation of the lung apices is somewhat obscured by the patient's chin. No focal consolidation or pneumothorax is identified. There are multilevel degenerative changes in the thoracic spine.
shortness of breath and left leg pain.
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Pa and lateral views of the chest were obtained. Lungs are clear, though hyperinflated without focal consolidation, effusion, or pneumothorax. Linear left lower lung density is stable and likely represents an area of scarring. Cardiomediastinal silhouette is stable. Atherosclerotic calcification along the aortic knob noted. A density projecting over the left mid lung likely reflects an old rib fracture and has been seen dating back to multiple prior studies from <unk>.
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Interval placement of an ng tube, with tip projecting in the stomach. Moderate cardiomegaly and mild pulmonary edema are unchanged since the prior study. No new focal consolidation, effusion, or pneumothorax.
<unk>-year-old man with stroke. evaluate ng tube placement.
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The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable.
history: <unk>m with sob // eval pneumonia
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A triangular-shaped irregularity at the left lung base appears stable since <unk>, and may represent the sequelae of postsurgical changes given the wire located in the left upper quadrant. Numerous mediastinal clips are also noted. There is no pleural effusion and no evidence of pneumonia. No evidence of pulmonary edema. The heart size remains top normal.
history: <unk>f with cardiac episode // evaluate for acute process
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Moderate cardiomegaly is chronic exaggerated by the low inspiratory volumes; mediastinal and hilar contours are otherwise normal. Lungs are clear. Sutures related to prior biopsy are noted projecting over the right mid lung. No pleural effusion or pneumothorax identified. No osseous abnormality is present.
pain with breathing. please evaluate for pneumonia versus alveolar hemorrhage.
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Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. There are mild degenerative changes in the thoracic spine
<unk>m w/ psc cirrhosis s/p liver transplant presented to clinic today c/o sob/lightheadedness, worsening over the past <num> weeks. // etiology of sob
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As before, the patient is status post median sternotomy and cabg. The right lung is clear. There is increased opacity at the base of the left lung suggesting atelectasis and a small pleural effusion. A left apical pneumothorax has resolved.
<unk> year old man s/p cabg // eval for progression of l ptx
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The heart appears enlarged. There are bilateral increased interstitial opacities suggestive of mild to moderate pulmonary edema. Bibasilar atelectatic changes are noted otherwise, the lungs are without focal opacity. No acute fractures are identified.
bilateral lower extremity edema, evaluation for pulmonary edema.
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Retrocardiac consolidation obscuring the left hemidiaphragm is concerning for pneumonia in the right clinical setting. The lungs otherwise clear. No pleural effusions or pneumothorax. Mild cardiomegaly and mediastinal contour are unchanged. Chronic right shoulder deformity is unchanged.
<unk> year old woman with fever on antibiotics, new lll abnormal coarse lungs sounds. // infiltrate? atelectasis?
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Heart size is mildly enlarged with mild hilar congestion. Mediastinal contour is normal. Lung volumes are low with basilar atelectasis and bronchovascular crowding there is no pleural effusion or pneumothorax. There is no acute osseous abnormality.
<unk>-year-old male with chest pain.
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No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Multiple old appearing lateral right-sided rib deformities are new since <unk>, but otherwise appear old, and involve at least the right lateral third, fourth, fifth, and sixth ribs, with possible overlying pleural thickening.
history: <unk>m with cp // eval for ptx
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In comparison with the study of <unk>, there is again some enlargement of the cardiac silhouette without definite vascular congestion. Opacification at the left base is consistent with volume loss and pleural fluid. Less prominent changes are seen at the right base.
sepsis, to assess for pneumonia.
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Pa and lateral views of the chest. No prior. The lungs are clear of focal consolidation. Biapical, right greater than left, pleural-based scarring is noted. Cardiomediastinal silhouette is within normal limits, noting some atherosclerotic calcifications at the aortic arch. Osseous and soft tissue structures are unremarkable, noting clips in the right upper quadrant suggesting prior cholecystectomy.
<unk>-year-old female with chest pain.
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Pa and lateral views of the chest provided. Dual-lead pacer projects over the left chest wall with lead tips extending to the expected location of the right atrium and right ventricle. Minimal blunting of the left cp angle could indicate a tiny effusion or pleural thickening. There is no pneumothorax. No definite focal opacities or signs of chf. The heart and mediastinal contours appear normal. No gross osseous injury. There is a vascular stent in the right axilla.
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Frontal and lateral views of the chest were obtained. There are low lung volumes and elevation of the right hemidiaphragm. Bibasilar opacities are seen which could in part relate to atelectasis, although underlying consolidation is not excluded. No large pleural effusion is seen, although small is difficult to exclude. The cardiac silhouette is difficult to assess due to bibasilar opacities. The bibasilar opacities could also relate to chronic aspiration.
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Nasogastric tube extends to the body of the stomach with the side hole distal to the esophagogastric junction. The appearance of the heart and lungs is essentially unchanged from the study of <unk>.
small-bowel obstruction, for ng tube placement.
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Lung volumes are unchanged compared to the prior study. The trachea is central. The cardiomediastinal contour is normal. A dual lead pacemaker is unchanged in appearance. There are persistent bilateral pleural effusions. Bibasilar atelectasis is unchanged, cannot exclude superimposed infection. No pneumothorax seen. Degenerative changes in the right shoulder.
<unk> year old woman with afib s/p ppm c/b rv ablation txfr intubated to ccu, now on floor and at end of course for copd // ?rll pna, progression of pleural effusions
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Right the tip of the feeding tube extends below the level of the diaphragm into the proximal jejunum. No focal consolidation, pleural effusion or pneumothorax identified. The size the cardiomediastinal silhouette is within normal limits.
<unk> year old man with cirrhosis and new dobhoff. // please confirm dobhoff placement
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The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. The lungs are clear. There is no pleural effusion or pneumothorax.
history: <unk>f with cough // acute process
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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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The lungs are hyperinflated but clear. Tortuous thoracic aorta is again demonstrated. Heart size is mildly enlarged. No pulmonary edema or pleural effusions. No evidence of pneumonia.
history: <unk>f with <unk> edema and sob // eval for pulm edema
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Compared <num> day prior, there has been interval intubation. The endotracheal tube terminates <num> cm above the carina. Given the course of radiopaque tubing projecting over the upper left lung, this is likely external to the patient. Mild pulmonary vascular congestion is present. No pulmonary edema. No large pleural effusion or pneumothorax.
<unk>f af (coumadin), chf p/w <num> days abd pain, nausea, fever today to <unk> s/p ex lap, <unk>'s // ett position
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Mild to moderate cardiomegaly is unchanged. Mediastinal contour is unremarkable. There is no focal lung consolidation, pleural effusion, or pneumothorax. There is increased interstitial markings bilaterally, consistent with mild interstitial edema.
<unk> year old woman with <num> days of cough and wheezing, evaluate for pneumonia
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Right chest wall pacing leads and in the right atrium and right ventricle, unchanged. The heart is top-normal in size. Prominence of the left mediastinum is unchanged and may represent pulmonary artery enlargement. The lungs are grossly clear. There is no pneumothorax or pleural effusion.
<unk>-year-old woman with fatigue and dizziness evaluate for pneumonia
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The patient is status post left upper lobectomy, apparently partial, as before, with associated volume loss including leftward shift of mediastinal structures and elevation of the left hemidiaphragm. A left apical cavity containing air and fluid appears similar in size although probably with more fluid and less air content than on the prior examinations. Persistent posterior basilar consolidation is noted but similar to the recent prior examinations allowing for differences in technique.
recent admission for pneumonia, now presenting with fever.
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Cardiac silhouette size is mildly enlarged. The aorta is unfolded. The mediastinal and hilar contours are unremarkable. There is mild pulmonary vascular congestion. Patchy opacities are noted in the lung bases without focal consolidation. No pleural effusion or pneumothorax is present. No acute osseous abnormality is seen.
history: <unk>m with fevers, chills, reported pneumonia, embolic strokes
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There has been no significant interval change compared to the prior study performed earlier on the same date. There is platelike atelectasis at the left lung base. No other consolidation, pleural effusion or pneumothorax. Cardiomediastinal contours are normal.
history: <unk>m with concern for pna // eval for acute process
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Since prior, there has been interval placement of right subclavian central venous catheter with tip projecting over the mid svc. There is no visualized pneumothorax. Et tube is in stable position. Enteric tube tip again seen in the distal esophagus and should be advanced for optimal positioning. No other change.
<unk>m with central line place // central line placement
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Small bilateral pleural effusions are new from the prior study with associated bibasilar opacity, left greater than right. Findings most likely represent partial lower lobe atelectasis although it pneumonia cannot be entirely excluded. Clinical correlation is recommended. There is no pulmonary edema or pneumothorax. The cardiomediastinal silhouette is stable.
<unk>f with shortness of breath, evaluate for pneumonia.
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Pa and lateral chest radiographs were provided. The lungs are hyperinflated. A new left chest wall pacemaker is seen with leads in the right atrium and right ventricle. Multiple mediastinal clips are present. Median sternotomy wires are intact. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. The heart size is normal. The bones are intact. There are mild degenerative changes in the thoracic spine.
<unk>-year-old man with new icd. evaluate lead placement.
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Study is slightly limited by patient rotation. Moderate enlargement of cardiac silhouette is re- demonstrated. Mediastinal and hilar contours are likely unchanged. Previous pattern of mild pulmonary vascular congestion appears mildly improved with no pulmonary edema is present. Patchy opacities in the lung bases persists, likely atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. Moderate multilevel degenerative changes are seen in the thoracic spine.
history: <unk>f with worsening shortness of breath
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As compared to the previous radiograph, the signs of pulmonary edema are increasing. These increasing signs of pulmonary edema lead to opacities at both lung bases, right more than left, and with visualization of kerley b lines. New minimal blunting of the right costophrenic sinus could suggest the presence of a small right pleural effusion. Status post sternotomy, cardiomegaly, left pectoral pacemaker.
fever, evaluation.
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Ap single view of the chest was obtained with patient in supine position. Comparison is made with the next preceding portable chest examination of <unk>. On the present image, the patient is intubated with the ett terminating in the trachea <num> cm above the level of the carina. No pneumothorax has developed. Overlying cables and electrodes appear to be external. Identified is a catheter approached from below passing the right atrium and the right ventricular outflow tract so to terminate in the proximal portion of the left pulmonary artery. A second external device consists of an intra-aortic balloon pump device that terminates appropriately in the upper portion of the descending aorta. Its termination point is just below the expected lower contour of the aortic arch. Chest findings have changed dramatically since the preceding chest examination of <unk> when the patient was in acute advanced pulmonary edema with additional evidence of bilateral pleural effusions. Pleural effusions have disappeared as at least on the supine image the lateral pleural sinuses are completely free. Lungs demonstrate still a typical pulmonary edema pattern with subtle haze bilaterally in the central lung regions. These findings, however, have improved markedly and there is no evidence of any remaining peripheral pulmonary parenchymal infiltrate. No pneumothorax is present in the apical area. The overall heart size is presently not significantly enlarged as can be identified on a single portable chest view. An ng tube is also seen to reach well below the diaphragm including its side port.
<unk>-year-old female patient with new anterior st elevation myocardial infarction and cardiogenic shock, now status post intra-aortic balloon pump placement and intubation evaluation for pulmonary edema and ett placement.
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Left lower lobe atelectasis has improved. The lungs are otherwise clear. The cardiac contour is stable and top normal. There is no pleural effusion or pneumothorax.
patient with tracheal resection and reconstruction.
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As compared to the most recent examination, there has been no significant interval change. The lung volumes are again noted to be low, resulting in crowding of the bronchovascular structures. No focal consolidation, pleural effusion, pneumothorax, or overt pulmonary edema is seen. Moderate cardiomegaly is unchanged. Mediastinal contours are stable.
shortness of breath.
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Known extensive right apical and left perihilar changes, as documented on the previous ct examination. In the remaining lung parenchyma, there is no evidence of acute changes. However, a lucency is now visible below the left hemidiaphragm. This might represent free intra-abdominal air. At the time of dictation and observation, <time> a.m., on <unk>, the referring physician, <unk>. <unk>, was paged for notification and the findings were discussed over the telephone.
metastatic renal cell cancer, evaluation.
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The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen.
cough, chest pain rule out pneumonia.
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There has been interval placement of a right-sided port-a-cath, terminating at the cavoatrial junction. No definite pneumothorax is seen. There is no pleural effusion. Right hilar opacity corresponding to patient's known right hilar mass is again seen, more prominent as compared to the prior study, relatively stable extent as compared to <unk> and <unk>, although increase in size is difficult to exclude on this study. The left lung appears clear. No new focal consolidation is identified. The cardiac and mediastinal silhouettes are stable. Again, the patient has known apical bullous pulmonary emphysema.
delirium and cough.
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Pa and lateral chest radiographs were obtained. The lungs are well expanded. There is a consolidation in the right lower lobe. There is no effusion or pneumothorax. The left lung is clear. The cardiac and mediastinal contours are normal.
cough and fever.
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Cardiac silhouette is enlarged and the aorta is tortuous, both without change. Lung volumes remain relatively low. Pulmonary vascularity is within normal limits accounting for this factor. Bibasilar areas of atelectasis are again demonstrated, slightly worse on the right and slightly improved on the left. There remains moderate elevation of the right hemidiaphragm anteriorly. No substantial pleural effusion. Diffusely distended loops of bowel are seen in the imaged portion of the upper abdomen, incompletely imaged on this chest radiograph exam.
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Pa and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.
<unk>m with chest pain and cough // eval for pna
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The lungs are hyperinflated, suggesting chronic obstructive pulmonary disease. Increased interstitial markings bilaterally is similar in extent as compared to the prior study, likely due to chronic lung disease. No definite acute focal consolidation is seen. No large pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal to mildly enlarged. The aorta is calcified.
<unk> year old woman with mechanical fall and l hip fx. // pre-op cxr.
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The inspiratory lung volumes are low. This accentuates the appearance of the cardiomediastinal silhouette. The cardiac silhouette is mildly enlarged. The patient is status post median sternotomy with intact wires. The mediastinal and hilar contours are within normal limits with a slightly unfolded thoracic aorta. The trachea is midline. The lungs are relatively clear without focal consolidation concerning for pneumonia, pleural effusion, or pneumothorax. The pulmonary vasculature is not engorged. The visualized upper abdomen is unremarkable.
nausea and malaise, here to evaluate for pneumonia.
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Heart size and mediastinal contours are unchanged, with unfolding of the thoracic aorta. The right basilar atelectasis and consolidation which was seen previously has improved in the interval. There is persistent elevation of the left hemidiaphragm and minimal plate-like atelectasis at the left lung base. Minimal increase in prominence of the upper zone pulmonary vasculature suggest borderline pulmonary vascular congestion. No pleural effusion. No pneumothorax. The osseous structures appear unchanged.
dementing illness and cervical myelopathy with low-grade temperature. evaluate for developing consolidation.
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The lungs are hyperinflated and there is bilateral hemidiaphragm flattening, suggesting chronic pulmonary disease. No focal consolidations, pleural effusions or pneumothorax. No new pulmonary nodules or masses. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.
<unk> year old woman s/p open partial right nephrectomy for papillary renal cell carcinoma// please evaluate for any abnormalities, r/o mets
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Pa and lateral views of the chest. The lungs remain clear. The cardiomediastinal silhouette is normal. No acute osseous abnormality detected.
<unk>-year-old male with cough.
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Portable ap chest radiograph. Lung volumes are very low with worsening perihilar and interstitial opacities consistent with pulmonary edema. There is also probably a mild pleural effusion on the left. The heart size is mildly enlarged. There is no pneumothorax.
brachial thrombectomy performed. patient has had a prior cabg and now is in chf with an ejection fraction of <num>%. evaluation for pulmonary edema.
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The cardiomediastinal and hilar contours are within normal limits. The lungs are clear. There is no pneumothorax. No bony abnormality. No free air below the right hemidiaphragm.
<unk>m with brbpr, sbo by osh imaging
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Cardiomediastinal silhouette and hilar contours are unremarkable. Lungs are clear. Pleural surfaces are clear without effusion or pneumothorax.
two days of cough and pleuritic chest pain. history of hiv.
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Single frontal view of the chest. Heart size is top normal and upper mediastinal contours are stable. Pulmonary vascular markings are indistinct, consistent with pulmonary edema. New bilateral lung base opacities are consistent with a large right and moderate left pleural effusion. Increased retrocardiac opacity may represent atelectasis or infection.
status post left foot amputation and cardiac arrest.
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The endotracheal tube ends <num> cm above the carina. The right internal jugular catheter ends in the lower svc. The upper enteric tube follows the expected course, ending below the diaphragm, although the tip is not seen. Aeration of the left lung is slightly improved from <unk> but similar to <unk>. Otherwise, there is little change in bilateral parenchymal opacities likely due to edema and bilateral pleural effusions. No pneumothorax.
lupus with left axillary necrotic lymph nodes status post washout, intubated.
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The lungs have normal volume. Normal appearance of the hemidiaphragms, no indication for pleural effusion on the frontal and lateral projections. The lateral radiograph only shows a very subtle parenchymal opacity, located in retrosternal region, that could represent a recent infectious process. Normal size of the cardiac silhouette. No hilar abnormalities. At the time of observation and dictation, <time> on <unk>, the referring physician, <unk>. <unk> was paged for notification.
churg-<unk> syndrome, increased shortness of breath, productive cough, evaluation for pneumonia. no comparison available at the time of dictation.
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There is mild vascular crowding, particularly at the right lung base. There is no focal consolidation or pleural effusion. The heart and mediastinum are within normal limits. There is no pneumothorax. Old healed left rib fractures are identified. There is no evidence of an acute rib fracture. No soft tissue abnormality is identified.
<unk> year old man with right chest wall pain // evaluate lungs and chest wall
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The lungs are clear without focal consolidation, effusion, or edema. Mild cardiomegaly is noted. No acute osseous abnormalities. Chronic presumably posttraumatic changes seen at the left coracoclavicular region.
<unk>m with renal xplant, t <num> // r/o pna
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There has been interval intubation with the endotracheal tube terminating approximately <num> cm from the chronic. An enteric tube tip and side-port terminates within the stomach. Heart size is normal. Mediastinal and hilar contours are unremarkable. Ill-defined small nodular opacities are demonstrated within both lung bases. Hazy opacity within the left hemi thorax suggest a layering pleural effusion. No large pneumothorax is identified. There are no acute osseous abnormalities.
history: <unk>m with intubation // ?tube placement
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Right internal jugular swan-ganz catheter terminates in proximal right pulmonary artery. Left pectoral pacemaker is in place. The non intended position of right atrial lead is unchanged at least since <unk>. The other lead terminates in the right ventricle. Et tube terminates <num> cm above the carina. Sternotomy wires are intact. Mild pulmonary edema is improved compared to <num> day ago. There is pulmonary vascular congestion. Moderately enlarged cardiomediastinal silhouette is similar to before. There is no pneumothorax or large pleural effusion.
<unk> year old man with cardiogenic shock // eval for pna vs pulmonary edema
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Frontal and lateral views of the chest. New right lung base patchy opacity silhouettes the right heart border and right hemidiaphragm, compatible with right middle and right lower lobe locations. New left retrocardiac opacity is also noted. Bilateral pleural effusions are small. No pneumothorax. The heart is of normal size with normal cardiomediastinal contours. No radiopaque foreign body.
<unk>-year-old male with cirrhosis. chest radiograph needed for liver transplant.
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In comparison with the study of <unk>, the monitoring and support devices remain in place. Continued substantial enlargement of the cardiac silhouette with bilateral pleural effusions and substantial pulmonary edema. Prominence of the main pulmonary artery is again consistent with pulmonary arterial hypertension. Retrocardiac opacification is again seen.
ascites and encephalopathy.
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There are low inspiratory volumes and underpenetration due to overlying soft tissues. Allowing for this, there is moderate to moderately severe cardiomegaly, straightening of left heart border trauma and effacement of the ap window. Mild prominence the right hilum is noted, but is likely accentuated by low inspiratory volumes. There is upper zone redistribution. There may be mild vascular plethora, but this is likely accentuated by low inspiratory volumes and underpenetration. No gross s right-sided effusion. The left costophrenic sulcus is clear. Minimal bibasilar atelectasis no calcified lymph nodes, apical scarring, hilar retraction and/or obvious calcified granuloma identified.
<unk> year old woman with need for central line hd // r/o tb, preop eval
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Compared to the prior study there is increase in the amount of central hazy alveolar infiltrate. There is pulmonary vascular redistribution a moderate cardiomegaly. There small bilateral effusions. There compressive changes at the bases. The right ij line and left-sided picc line are unchanged. .
<unk> year old man s/p pod #<num> avr tissue valve with continued hct drop // r/o acute bleed
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The lungs are clear. The heart is normal in size. The mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen. There is re-demonstration of levoscoliosis of the lumbar spine.
new-onset chest pain. assess for acute process.