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Ap upright portable chest radiograph was provided. Tracheostomy tube is again noted. Midline sternotomy wires and left arm picc line are unchanged. There are bilateral pleural effusions with lower lobe consolidations which could represent atelectasis or pneumonia. Overall, there has not been significant change from the prior exam. No pneumothorax is seen.
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Pa and lateral views of the chest provided. Lung volumes are low. Midline sternotomy wires are noted. Allowing for low lung volumes, the lungs appear clear without focal consolidation, large effusion or pneumothorax. No signs of congestion or edema. The heart is upper limits of normal. Mediastinal contours unremarkable. No bony abnormalities. No free air below the right hemidiaphragm.
<unk>f with mechanical fall; l distal tibial fx, l <unk> metatarsal fx.
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In comparison with chest radiograph from <unk>, a residual opacity in the right juxtahilar region likely represents atelectasis. Cardiopulmonary support devices are in standard placements. Overall, there is no relevant change.
<unk> year old man with rt subcortical stroke with fever and vap // please assess for infectious etiology
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The cardiac silhouette size is normal. Mild atherosclerotic calcifications are seen within the aortic arch. Mediastinal and hilar contours are within normal limits. Mild prominence of the pulmonary vascular markings suggest mild pulmonary vascular congestion. Additionally, scattered patchy opacities are seen within the left upper lobe, and both lung bases, findings which are concerning for infection in the correct clinical setting. No pleural effusion or pneumothorax is identified. There are moderate multilevel degenerative changes noted in the thoracic spine.
altered mental status, cough
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The cardiac, mediastinal and hilar contours are normal. Lungs are clear and the pulmonary vasculature is normal. No focal consolidation, pleural effusion or pneumothorax is present. There are no acute osseous abnormalities.
cough for <num> week and lumbar spine pain.
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Patient is known with right lung mass and significant right pleural effusion that has been recently drained. Since the removal of the drain, the pleural fluid is slowly reaccumulating and is at least moderate. There is no pneumothorax. New left lower lung, moderate opacification since yesterday x-ray could reflect atelectasis, small pleural effusion or even aspiration. Moderate cardiac contour enlargement is unchanged.
patient with somnolence, evaluate for effusion, consolidation.
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Pa and lateral views of the chest provided. Faint platelike atelectasis is noted in the left lower lung. Otherwise the lungs are clear. No pleural effusion or pneumothorax is seen. The cardiomediastinal silhouette is normal. Bony structures are intact. A small calcific density abutting the right humeral head laterally may reflect tendinopathy.
<unk>f with l knee pain, chest pain s/p fall
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In comparison with the study of <unk>, the monitoring and support devices are unchanged and in standard position. There is continued enlargement of the cardiomediastinal silhouette with interval improvement of the pulmonary vascular congestion and bilateral pleural effusions. The basilar compressive atelectasis is stable when compared to the prior.
<unk> year old man with persistent respiratory failure // interval changes
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Frontal and lateral views of the chest. The cardiac silhouette is enlarged since <unk>, which may reflect either cardiomegaly or a pericardial effusion. The lungs are clear without focal consolidation, pleural effusion, or pneumothorax.
left chest pain.
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The cardiac silhouette is normal in size. The hilar and mediastinal contours are stable. Lung volumes are decreased. There is no focal consolidation, large pleural effusion or pneumothorax.
history: <unk>m with chest pain, dyspnea // eval for acute process
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The cardiomediastinal and hilar contours are normal. The lungs are clear. There is no pleural effusion or pneumothorax. No displaced rib fracture is identified on these lung-technique films.
<unk>-year-old female status post mvc, now with right chest wall pain.
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The patient is status post median sternotomy and cabg. Moderate enlargement of cardiac silhouette is present. The aorta is tortuous and demonstrates diffuse atherosclerotic calcifications. Cephalization of pulmonary vascular markings is suggestive of mild pulmonary vascular engorgement. Patchy ill-defined opacity in the right mid lung field is noted. No focal pleural effusion or pneumothorax is visualized. Streaky atelectasis is demonstrated at the lung bases. There are no acute osseous abnormalities.
history: <unk>m with atrial flutter, hyponatremia, and leukocytosis
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The lungs remain hyperinflated. There is thoracic scoliosis. The cardiac silhouette is enlarged. No focal consolidation is seen. No large pleural effusion or pneumothorax is seen. There is no pulmonary edema. The aorta is calcified. There is a least <num> left-sided rib fracture, involving the posterior lateral left sixth rib. The study is not sensitive for detection of rib fractures ; if there is clinical concern for additional injury, ct is more sensitive. Severe degenerative changes at the shoulder joints partially imaged.
history: <unk>f with fall onto left side // r/o fx, ich
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Comparison to <unk>, <time>. As compared to the previous image, the area of severe right-sided loculated pleural fluid and right lower lobe consolidation are unchanged. The monitoring and support devices are in unchanged position. Moderate cardiomegaly persists. Unchanged appearance of the left lung, with left lower lobe opacification.
<unk> year old man with lvad // interval chnage
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In comparison with the study of <unk>, there is an endotracheal tube in place. It is difficult to precisely see the tip, but it appears to be extremely close to the carina and should be pulled back several cm. This information was telephoned to the resident taking care of the patient. Otherwise, there is slightly better inspiration. Continued opacification at the left base is consistent with atelectasis and effusion. In the appropriate clinical setting, supervening pneumonia would have to be considered.
for et tube placement.
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There is a moderate to large right apical pneumothorax. The right chest wall port tip ends in the low svc. There is mild pulmonary vascular congestion and mild cardiomegaly. There may be a small left pleural effusion. There is no focal consolidation.
port placement, r/o pneomothorax in o.r.
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Ap portable view of the chest. The left picc ends at the confluence of brachiocephalic veins. Moderate bilateral pleural effusions are unchanged as well as mild pulmonary vascular congestion. The large pseudoaneurysm from the aortic arch is unchanged in size. No pneumothorax. Cardiomegaly is unchanged. Absence of the right humeral head is again seen.
question fluid overload.
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Cardiac, mediastinal and hilar contours are normal. The lung volumes are low. No focal consolidation, pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. Multiple clips compatible with prior cholecystectomy are again seen in the upper abdomen.
chest pain.
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No pulmonary edema. Slightly decreased left lung volume with slight elevation left hemidiaphragm suggestive of mild basilar atelectasis. Small bilateral pleural effusions, left worse than right. The cardiomediastinal and hilar contours are normal. Stable calcification of the aortic arch. There is air beneath the diaphragms bilaterally as expected status post abdominal surgery.
<unk> year old man with rectal cancer s/p colostomy, <unk> <unk> placement unable to wean o<num> pod <num> // please evaluate for pulmonary edema or pneumonia
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Lung volumes are relatively low. There is streaky retrocardiac opacity on the frontal and lateral views. Elsewhere, lungs are clear. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. There is no free intraperitoneal air.
<unk>m with epigastric pain when breathing, chills // r/o pna, herniation
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Descending aorta stent graft is unchanged, done for an aneurysm. Bibasilar mild atelectasis and left costodiaphragmatic blunting is unchanged. There is no pneumothorax. The right-sided jugular line ends in lower svc.
patient with hypertension, copd, tvar, new leukocytosis. please evaluate for new edema, infiltrates, effusions.
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Single frontal chest radiograph demonstrates a right-sided central venous catheter terminating in the mid svc. Mediastinal and pleural drains are stable in position. There is persistent but improved bilateral patchy opacifications, which may represent resolving background pulmonary edema; however, there is a persistent, though again slightly improved, opacity within the right upper lobe and left mid lung, which may suggest superimposed pneumonia. No pleural effusion identified. No definite pneumothoraces are noted.
status post cabg/maze/<unk> ligation. evaluate for pneumothoraces.
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Frontal and lateral views of the chest are compared to previous exam from <unk>. The lungs are clear of consolidation or effusion. Cardiomediastinal silhouette is within normal limits. Tortuous aorta is noted. Osseous and soft tissue structures are unremarkable. There is increased lucency at the right lung base, likely below the hemidiaphragm suspicious for intraperitoneal air.
<unk>-year-old female with fever, one week status post bowel obstruction and recent bowel surgery.
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The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified.
<unk>m who blacked out and got in a fight last night, multiple cuts and bruises. // fracture? bleed? forieng body in left hand
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Cardiomediastinal contours are normal. Lungs and pleural surfaces are clear. No pleural effusion or acute skeletal finding.
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A small left apical pneumothorax has slightly decreased in size since the prior exam. There is no right pneumothorax. The lungs are clear without a consolidation, pulmonary edema or pleural effusion. The cardiomediastinal silhouette is normal.
known left apical pneumothorax. evaluate for change.
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The patient is status post recent median sternotomy and coronary artery bypass surgery. Cardiomediastinal contours are stable in appearance compared to previous post-operative radiographs. Moderate left pleural effusion has slightly increased in size since the previous radiograph, and is associated with adjacent left basilar atelectasis. On the other hand, a small right pleural effusion has decreased in size and nearly resolved.
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The left pectoral port catheter tip terminates in the mid svc, unchanged. Cardiomediastinal borders are stable. Lung volumes are low. Mild left basilar atelectasis is present. No focal consolidation, pleural effusion, or pneumothorax. Chronic right-sided and left-sided pleural thickening with bilateral rib deformities is unchanged from prior studies. Surgical clips are seen in the left upper quadrant.
history: <unk>m with fever, hypoxic. evaluate for pneumonia and for port placement.
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As compared to the previous radiograph, there is no relevant change. Unchanged appearance of the left pleural effusion and the left chest tube. Unchanged dimension of the left pleural effusion. No visible evidence of pneumothorax. Unchanged size of the cardiac silhouette. Unchanged right picc line and appearance of the right lung parenchyma.
intermittent fevers, left pleural effusion, left chest tube, evaluation.
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Anterior cervical spinal fusion hardware is partially imaged. The cardiomediastinal silhouettes are stable and within normal limits. The bilateral hila are unremarkable. The lungs are clear without focal consolidation. There is no pulmonary vascular congestion. There is no pneumothorax or pleural effusion. There is no evidence of displaced rib fracture.
<unk>-year-old woman with a fall, evaluate for fracture.
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Pa and lateral chest radiographs were obtained. The lungs are well expanded and clear. There is no focal consolidation, effusion, or pneumothorax. Cardiac and mediastinal contours are normal.
cough and fever.
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Ap upright and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.
<unk>f with cough, shortness of breath // evaluate for pneumonia
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There is a left-sided port with the tip terminating in the mid svc. The lungs are clear without evidence of focal consolidations concerning for pneumonia. There is no pleural effusion or pneumothorax. The heart size is normal. Note is made of mild bibasilar atelectasis. The visualized osseous structures are unremarkable.
history of glioblastoma with new cough. please evaluate for pneumonia.
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There is dense consolidation in the right upper lobe. There is also focal opacity at the posterior costophrenic angles on the lateral view which is unchanged from prior. The lungs are otherwise clear. Moderate cardiomegaly is unchanged. Left chest wall triple lead pacing device again seen with lead tips in right atrium, right ventricle, and coronary sinus. No acute osseous abnormalities.
<unk>m with recent diagnosis of pneumonia p/w worsening respiratory status // eval for pneumonia v. chf
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The dobbhoff tube terminates within the stomach, and no coiling is noted within the hypopharynx. There is a left internal jugular central venous line which terminates near the cavoatrial junction. Lungs are clear of focal consolidation, and there is likely a layering right pleural effusion.
<unk> year old man status post liver transplant currently having rejection, dobbhoff repositioned due to coiling.
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Right mainstem bronchus intubation, recommend retraction of endotracheal tube. Low lung volumes accounting for apparent bronchovascular crowding. No focal consolidations seen. Streaky retrocardiac opacity likely represents atelectasis. There is no pleural effusion or pneumothorax. Median sternotomy wires are present.
<unk>m with sdh and intubated the evaluate endotracheal tube placement.
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The new endotracheal tube terminates <num> cm from the carina. An enteric tube terminates at the level of the ge junction and should be advanced for optimal placement within the stomach. A small left pleural effusion is increased in size compared with the prior study. Left mid lung masslike opacification has increased in density compared to prior studies and better characterized by ct of <unk>. Hyperinflation is similar to multiple prior studies. There is no new focal consolidation, pneumothorax, or pulmonary edema.
<unk>f with copd in resp distress intubated, evaluate endotracheal tube placement.
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Lung volumes are low. The heart size is top normal and accentuated at due to low lung volumes. The aorta is mildly unfolded. The mediastinal and hilar contours are unremarkable. The pulmonary vasculature is normal. There are minimal linear opacities within the lung bases compatible with subsegmental atelectasis. No focal consolidation, pleural effusion or pneumothorax is seen. There are mild degenerative changes in the thoracic spine.
chest pain.
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The right internal jugular central venous line tip is at the cavoatrial junction appropriately positioned. The heart is enlarged. There are increased vascular markings consistent with congestion. There are trace bilateral pleural effusions and bibasilar opacities which could reflect atelectasis or infection.
cholangiocarcinoma. with fever and abdominal pain. check ij placement.
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The cardiomediastinal silhouette is stable. There is no pneumothorax. Diffuse parenchymal scarring worse at the right lung base in the right mid lung is again seen with a moderate amount of architectural distortion. There are numerous calcified granulomas, worse in the left midlung. Right-sided pleural thickening is unchanged. Moderate rightward tracheal deviation is likely related to parenchymal scarring.
history: <unk>m with <unk> edema, cough // acute process
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As compared to the previous radiograph, the left chest tube has been removed. There is no evidence of pneumothorax. Appearance of the left lung is unchanged. On the right, a pre-existing opacity in the right upper lobe has minimally decreased in extent and severity. Otherwise, there is no relevant change. The remaining monitoring and support devices are constant, with the exception of the dobbhoff catheter that has been removed in the interval. Unchanged sclerotic spot in the left humerus and status post right humeral fracture.
status post chest tube removal, evaluation.
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Compared to the previous radiograph, there is no relevant change. The monitoring and support devices are in constant position. There is constant evidence of fluid overload and a likely small left pleural effusion with subsequent retrocardiac atelectasis. The changes are not substantially changed since the previous examination. The right pleural drain is in constant position. No evidence of pneumothorax.
shortness of breath, severe aortic stenosis, volume overload.
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The right hemidiaphragm is elevated with mild adjacent atelectasis. Linear atelectasis is noted at the left lung base. There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits.
history: <unk>f with seizure // evaluate for acute process
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Moderate pulmonary edema is increased compared to <unk>. Cardiac silhouette is larger. There is no pneumothorax. Left lower lobe collapse is persistent. Small left pleural effusion is stable. Right internal jugular venous approach temporary pacer terminates in right ventricle. Sternotomy wires are intact. Tavr device is in expected position.
<unk> year old man s/p tavr with hypoxia // please evaluate for pulmonary edema, pna
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There are low lung volumes, which accentuate the cardiac silhouette and bronchovascular structures. There is no focal consolidation, pleural effusion or pneumothorax.
fevers. rule out pneumonia.
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A right subclavian infusion port ends in the mid svc. Linear opacities at the left base are stable from prior radiographs and most likely chronic atelectasis. There is no pleural effusion, edema, or pneumothorax. The cardiomediastinal silhouette is normal.
rectal cancer, hiv, with new fever and wheezes. evaluate for pneumonia.
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Following left thoracentesis, a left pleural effusion has resolved, but a small left basilar pneumothorax has developed. There has been associated improved aeration in the left retrocardiac region with near resolution of previously present atelectasis. Otherwise, no relevant short interval change. The presence of pneumothorax has been communicated by telephone with <unk> <unk>, at <time> a.m. On <unk> at the time of discovery.
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Frontal and lateral views of the chest were obtained. There is no focal consolidation, pleural effusion or pneumothorax. The lungs are slightly hyperinflated. Mild cardiac enlargement and aortic tortuosity are unchanged. There is eventration of the right hemidiaphragm. The pulmonary vasculature is within normal limits. A <num>mm nodule in the left mid lung is new from <unk>. The patient is status post right mastectomy. Multiple thoacic vertebral compression fractures are unchanged.
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Portable supine frontal radiograph of the chest demonstrate the ett ending <num> cm above the carina. A right internal jugular central venous catheter ends in the mid svc. An enteric tube passes below the diaphragm with tip out of view at the inferior edge of the image. Pulmonary edema and mild cardiomegaly is stable compared to the prior study. Small bilateral pleural effusions are again noted. The left upper lobe consolidation is perhaps slightly improved compared to the prior.
left upper lobe pneumonia, intubated. chest tube placement.
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Ap view of the chest provided. Since prior study from <num> day ago, bilateral chest tubes and mediastinal drains have been removed. Right subclavian line terminates in the low svc. There is a new right apical pneumothorax. Retrocardiac atelectasis continues to improve. Mild edema within the left lung is minimal. Small left pleural effusion is unchanged. The postoperative cardiomediastinum is stable.
<unk> year old woman with s/p mvr // eval for ptx
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There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits.
history: <unk>m with c/o cp and sob after fall // ? fx
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Heart is upper limits of normal in size. Pulmonary vascular congestion is accompanied by mild interstitial edema. Note is also made of a patchy area of increased opacity in the right infrahilar region. This could be due to focal atelectasis, aspiration or an early focus of pneumonia. Short-term followup radiograph may be helpful in this regard. Bullous emphysema is present at the right apex, but there is no evidence of a pneumothorax.
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Heart size is normal. Enlargement of the right paratracheal stripe and left hilus is compatible with lymphadenopathy as detected on the prior ct. Emphysematous changes are most pronounced within the upper lobes. Numerous calcified small pulmonary nodules are again seen bilaterally, likely due to prior granulomatous disease or previous varicella infection. New opacification of the right lower lobe with small right pleural effusion is concerning for pneumonia. No pneumothorax is identified. There is no pulmonary vascular congestion. Partially imaged is cervical spinal fusion hardware and laminectomies. No acute osseous abnormality seen.
shortness of breath.
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There is a moderate size left pleural effusion with adjacent compressive collapse. The right lung is clear. Cardiomediastinal and hilar contours are normal. No pneumothorax.
history: <unk>m with r hand weakness/numbness for <num> days. new seizure today. has been having headaches as well. new left sided pleural effusion. // please do with ctv. evaluate for venous thrombus.
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Small left apical pneumothorax is slightly increased compared to <num> day prior. There has been reaccumulation of small left pleural effusion. Left chest tube is noted projecting over the left basal pleural space. Cardiac silhouette is normal size.
<unk> year old woman with ?pleural effusion // ?pleural effusion
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As compared to the previous radiograph, the previously not visible opacities in the upper lobes, documented on the previous ct examination, are now clearly visible on the chest radiograph. This suggests substantial progression of disease. At the level of the left hilus and the left lung bases, the disease is also clearly progressive. Moderate cardiomegaly persists. No pleural effusions. At the time of dictation and observation, <time> a.m., on the <unk>, the referring physician <unk>. <unk> was paged for notification.
bone marrow transplant, evaluation for pneumonia.
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Right internal jugular central venous catheter terminates in the proximal to mid superior vena cava, with no visible pneumothorax. The cardiac silhouette is enlarged and is accompanied by new interstitial edema and persistent small pleural effusions.
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In comparison with study of <unk>, there is little change. No evidence of acute cardiopulmonary disease. Central catheter remains in place and there is again evidence of a fracture of the proximal right humerus.
trauma.
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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 chest pain // ?acute cardiopulmonary process?
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An infusion port overlies the right chest with catheter terminating in the mid to the low svc. Cardiomediastinal silhouette, pulmonary vasculature, and aorta are within normal limits. There is no area of consolidation or pulmonary nodule. There is no pleural effusion.
<unk> year old man with lymphoma // cough; low grade fevers; assess for abnormality cough; low grade fevers; assess for abnormality
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There is no focal consolidation, pleural effusion or pneumothorax. <num> cm left lower lung nodules unchanged from prior examinations. The cardiomediastinal silhouette is normal. The imaged upper abdomen is unremarkable. The bones are intact except for mild degenerative changes of the thoracic spine.
history: <unk>f with recent skin bx requiring intubation p/w dyspnea // r/o pna
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Pa and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. Mild to moderate cardiomegaly is similar to prior. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.
history: <unk>f with sob // r/o pna
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Ap portable upright view of the chest. Low lung volumes limits assessment. The lungs appear clear. No large effusion or pneumothorax. Cardiomediastinal silhouette appears prominent likely in part secondary to technique. No discrete fracture identified.
<unk>f with seizure history presents after seizure at pain management
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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.
history: <unk>f with fevers, cough // pna?
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Frontal and lateral views of the chest were obtained. The lungs are hyperinflated. There is no focal consolidation, pleural effusion or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal. Clips projecting over the neck may be related to prior thyroid surgery.
asthma exacerbation and cough.
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Low lung volumes are present. There is moderate cardiomegaly which is relatively unchanged compared to the prior study. The aorta remains tortuous with calcification of the aortic knob again noted. Mild pulmonary edema is new when compared to the prior study. No large pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. Previously noted right picc has been removed.
chest pain and shortness of breath.
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Overall similar appearance of the chest when allowances are made for slight patient rotation on the current study. No new areas of consolidation are identified within the lungs to suggest the presence of pneumonia.
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Pa and lateral views of the chest were provided. The lungs are clear bilaterally without focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. The imaged bony structures are intact. No free air is seen below the right hemidiaphragm.
<unk>-year-old female with toxic exposure, question pneumonitis.
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There is no focal consolidation, pleural effusion or pneumothorax. The heart remains enlarged as seen on prior studies. The imaged upper abdomen is notable for surgical clips in the right upper quadrant suggesting prior cholecystectomy. The bones are intact.
<unk>f with nausea, vomiting // ? pna
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The cardiomediastinal and hilar contours are within normal limits. The lungs are clear without focal consolidation, pleural effusion, pulmonary edema or pneumothorax.
history: <unk>f with luq pain // luq pain
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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. No displaced fracture is identified.
chest pain
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Portable chest radiograph demonstrates interval removal of swan-ganz catheter and ett and remaining right-sided central venous sheath with tip terminating in the upper svc. There is stable cardiomegaly with improving postoperative pneumopericardium. No chest tubes or mediastinal drains are evident. A fold is identified crossing left ribs <unk>, possibly a pleural fold due to small apical pneumothorax; however, unable to assess for lung markings beyond this fold due to overlying medical devices. There is redemonstration of prominent interstitial markings and hazy vascular consistent with pulmonary edema with increased lucency in the left upper lobe. However, unclear if this is related to possible pneumothorax or improved aeration. Trace pneumoperitoneum newevident and may be due to previous reported pneumopericardium. Please correlate with any abdominal surgical history, instrumentation and clinical exam. Slightly increased retrocardiac opacity may reflect a combination of atelectasis and pleural effusion though in the appropriate clinical setting, infectious process cannot be excluded.
status post avr and chest tube removal, please evaluate for pneumothorax.
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Compared to the prior study, subsegmental atelectasis at both bases is significantly increased. The possibility of associated early infiltrates cannot be excluded, though no frank consolidation is seen. The cardiomediastinal silhouette is unchanged. There is mild vascular plethora, without overt chf. No effusion.
<unk> year old woman with pv now with pe and worsening wheezing // please assess for pneumonia, pulmonary edema.
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A portable frontal chest radiograph demonstrates unchanged cardiomegaly. There is mild pulmonary edema. Retrocardiac opacity is likely due to edema and superimposed atelectasis. No pleural effusion or pneumothorax is identified.
shortness of breath. evaluate for pulmonary edema.
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There is moderate to severe thoracic dextroscoliosis which complicates the interpretation of this study. In comparison most recent study, the right lung volume is lower and the left lung volume is slightly increased. The lower lung volume on the right could be due to worsening atelectasis and/or worsening pleural effusion. Slight improvement of left pleural effusion but worsening of lower lung atelectasis. The apices are difficult to assess due position of the patient's neck and chin overlying these regions. Severe cardiomegaly is stable.
ms <unk> is a <unk>f with history of hfpef (><unk>%), refractory htn, ckd iv who presented with lower extremity edema and cough developing over the past week concerning for acute decompensated heart failure. // pulmonary edema
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The et tube continues to be slightly high, at the thoracic inlet. Ng tube tip is off the film, at least in the stomach. There continue to be low lung volumes with pulmonary vascular re-distribution. There are new/increased opacities in both lower lungs. While this could be due to volume loss, early infiltrate cannot be excluded.
ng tube placement.
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Low lung volumes. Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. There is bilateral lower lung atelectasis. Lungs are otherwise clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.
<unk>f with hypoxia. evaluate for pneumonia
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The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The lungs appear clear. Bony structures are unremarkable.
chest pain and lightheadedness. history of transient ischemic attack.
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The cardiac, mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.
influenza like illness.
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As compared to the previous radiograph, the endotracheal tube has been pulled back. The tip of the tube now projects approximatively <num> cm above the carina. Nasogastric tube and right internal jugular vein catheter are unchanged. The retrocardiac atelectasis has been minimally increasing. There is no overt pulmonary edema and no evidence of larger pleural effusions or pneumonia. Unchanged minimal atelectatic opacity at the medial aspect of the right lower lung.
status post cardiac arrest and intubation, evaluation.
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Frontal and lateral chest radiograph demonstrate normal cardiomediastinal and hilar contours. On a background of mild pulmonary edema, there are stable bibasilar opacifications including a domed posterior pleural based opacification likely reflecting rounded atelectasis. There is stable prominence of the right lateral pleura, likely combination of small loculated pleural fluid and pleural thickening. Small amount of fluid tracks along the minor fissure. No pneumothorax evident. Left-sided port-a-cath terminates at the cavoatrial junction.
hypoglycemia, neutropenia, evaluate for pneumonia.
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The lungs are well inflated. No chf, focal infiltrate, effusion, or pneumothorax is detected. Right paratracheal soft tissues could represent vascular structures in someone of this age. Slight leftward displacement of the trachea is noted. While this could be positional, it raises the possibility of displacement by the thyroid. The heart is at the upper limits of normal in size. The aorta is unfolded. The right hemidiaphragm is slightly elevated. No free air is seen beneath the diaphragm. Mild to moderate multilevel degenerative changes are noted in the thoracic spine.
history: <unk>f with pleuritic chest / flank pain // evaluate for acute process
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There is mild interstitial edema and a small right pleural effusion. The heart is top-normal in size, and there is no focal consolidation. The mediastinal contours are normal.
<unk>-year-old female with shortness of breath. thigh for acute process.
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Right pigtail pleural catheter remains in place, with a persistent moderate-sized partially loculated right pneumothorax, which remains most marked at the right base. Multi-cavitary consolidation within the right upper lobe and multiple poorly defined bilateral nodular opacities and foci of consolidation appear largely unchanged over the short interval between the two studies. Small left pleural effusion is also similar.
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Low lung volumes are noted with crowding of the bronchovascular markings. There is no confluent consolidation or overt pulmonary edema. There is no pneumothorax or effusion. Right picc is seen with tip projecting over the upper svc. No displaced fractures identified.
<unk>m with ams in setting of thrombocytopenia, neutropenia, possible fall // eval spontaneous vs traumatic hemorrhage
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A single portable frontal radiograph of the chest was acquired. There is redemonstration of a right picc, ending in the low svc, not significantly changed in position. The lungs are clear. Mild-to-moderate cardiomegaly is not significantly changed. There are no pleural effusions. No pneumothorax is seen.
picc not functioning properly. evaluate position.
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As compared to the previous image, there is no relevant change. Mild, potentially increased atelectasis at the left lung base, the presence of a minimal left pleural effusion cannot be excluded. The right chest tube is in unchanged position. There currently is no evidence of right pneumothorax. The nasogastric tube is unchanged. Unchanged size of the cardiac silhouette. Minimal increase in right basal density, likely to be caused by a lesser inspiratory effort. Unchanged appearance of the heart.
chest tube put on waterseal.
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Right upper lobe opacity is unchanged. Left lower lobe atelectasis in the retrocardiac region is persistent. Stable bilateral small pleural effusion is larger on the left. Cardiac silhouette is exaggerated by low lung volumes. Mild pulmonary edema is marginally improved. Right internal jugular venous catheter terminates in mid svc. Cervical spinal hardware is in unchanged position.
<unk> year old woman with nash cirrhosis and hcap // eval for interval change
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Ap single view of the chest has been obtained with patient in sitting upright position. Available for comparison are the next two preceding portable chest examinations of <unk> and <unk>. In comparison with the next preceding study, the patient has now been extubated. No pneumothorax has developed. Again noted is a rather sizable parenchymal infiltrate in the left lower lung field similar to what has been shown on previous examinations as well as an initial chest ct of <unk>. These densities are compatible with aspiration pneumonitis given patient's history. There is probably some mild cardiac enlargement, but the portable examination and the uncooperative patient added to makes it difficult to establish clear findings. There is no congestive pulmonary vascular pattern in the accessible areas. Lateral pleural sinuses are free, which excludes larger pleural effusions. As on previous examination, there is evidence of an anterior cephalization plate overlying the lower cervical spine area.
<unk>-year-old female patient with fever and cough, initial chest ct was suspicious for pneumonia. evaluate for interval change and consolidation.
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The lungs are well expanded. Several punctate calcified nodular opacities are seen scattered in the right lung corresponding to findings on ct examination. Lungs are otherwise clear. Mediastinal contour, hila, and cardiac silhouette are normal. No pleural effusion or pneumothorax.
<unk>f <num> days s/p physical fight // r/o internal bleed/internal process
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Pa and lateral chest radiograph demonstrate no focal opacity convincing for pneumonia. Heart size is within normal limits. The hilar mediastinal contours are unremarkable. There is no pulmonary edema, pleural effusion, or pneumothorax. No acute osseous abnormality is detected.
<unk>-year-old female with chest pain and back pain.
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As compared to the previous radiograph, the extensive left pleural effusion, occupying approximately one-third of the left hemithorax, is unchanged in extent and distribution. In unchanged manner, areas of atelectasis are seen at the left lung bases and in the retrocardiac lung areas. The ventilated parts of the left lung as well as the right lung are unremarkable. Unchanged shape of the cardiac silhouette.
pleural effusion, evaluation.
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Endotracheal tube terminates about <num> cm above the carina. Trachea is markedly shifted through the left due to a large right superior mediastinal mass which arises from the thyroid gland as demonstrated on neck ct of <unk>. Heart is enlarged and accompanied by mild pulmonary vascular congestion. A new area of airspace opacity has developed in the right infrahilar region, and could reflect asymmetrical edema. Differential diagnosis includes an acute aspiration event. Bilateral small pleural effusions are also demonstrated.
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Frontal on lateral chest radiographdemonstrates well expanded and clear lungs.no pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. Limited assessment of the upper abdomen is within normal limits.
shortness of breath like pneumonia. assess for pneumonia.
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Lungs are fully expanded and clear. There is no focal consolidation, effusion, or pneumothorax. Mediastinal and hilar contours are normal. Heart size normal.
history of pulmonary embolism, pre vq scan.
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Left lower lobe atelectasis is again present. There are no focal consolidations concerning for pneumonia. There is no pneumothorax or pulmonary edema. The aorta is again tortuous. The right lung is essentially clear. No pleural effusion is present. Cardiac sized is again enlarged.
back pain, question pneumonia.
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Lungs are hyperexpanded. Previously described new subtle opacities in the lower lungs have resolved. Multifocal areas of bronchiectasis and multifocal lung nodules appear similar. Cardiomediastinal contours are stable in appearance. No pleural effusion or acute skeletal findings.
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Frontal and lateral views of the chest are obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are stable and unremarkable.
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Comparison is made to the prior study performed <num> hours earlier. There has been some retraction of the endotracheal tube which is now <num> cm above the carina. There are bilateral central venous lines with distal lead tips in the mid to distal svc. There has been worsening of the airspace opacities throughout both lung fields which may be due to ards with superimposed pulmonary edema. There is a left retrocardiac opacity. No pneumothoraces are seen.
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A single portable chest radiograph was obtained. Lung volumes are low but clear. The hila appear mildly enlarged. No effusion or pneumothorax is present. There are degenerative changes of the left shoulder.
<unk>-year-old woman with elevated white blood cell count and nausea, rule out pneumonia.