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The lung volumes are low. The heart is at the upper limits of normal size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There are no pleural effusions. Bony structures are unremarkable.
left-sided chest pain.
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Frontal and lateral views of the chest are compared to previous exam from <unk>. On the current exam, the lungs are clear of consolidation. There is no effusion, no pneumothorax. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable.
<unk>-year-old male with hypotension. question pneumonia.
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The heart is at the upper limits of normal size. The mediastinal and hilar contours appear within normal limits aside from patchy calcifications along the aortic arch. There are no pleural effusions or pneumothorax. Mild degenerative changes are noted along the mid thoracic spine.
dry cough.
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Compared with <unk> at <time>, left base atelectasis is probably increased. Poor delineation of the left costophrenic angle is new and could relate to atelectasis or small amount of pleural fluid. Left ventricular silhouette is also slightly larger. Otherwise, i doubt significant interval change. The left-sided pacemaker is unchanged , with lead tips over right atrium and right ventricle. No pneumothorax is detected.
<unk> year old woman with s/p ppm // r/o pneumo and lead placement
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Frontal and lateral views of the chest were obtained. There is mild left basilar atelectasis without definite focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No overt pulmonary edema is seen.
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The lungs are clear without consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.
<unk>m with chest pain // eval for ptx or cardiomegaly
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In the interval, both the left and right chest tubes were removed. While the chest tube removal on the left was without consequences, a <num>-cm apicolateral pneumothorax is seen on the right. The right hemithorax, however, shows no evidence of tension. The other monitoring and support devices, including the two left-sided central venous access lines and the endotracheal tube, are unchanged. No changes in lung volumes or heart size. The pre-existing right lower lung and left upper lung opacities are constant. At the time of observation and dictation, <time> p.m., on <unk>, the referring physician, <unk>. <unk>, was paged for notification.
status post cabg. rule out pneumothorax.
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The patient has known and documented lung fibrosis, with small lung volumes and reticular opacities. There is no chest radiographic evidence of new or additional parenchymal changes. Notably, there are no changes suggesting acute lung disease. Borderline size of the cardiac silhouette. No evidence of pleural effusions.
scleroderma, nsip, evaluation for acute changes.
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The heart is normal in size. There is redemonstration of calcified hilar and mediastinal lymph nodes, as seen previously on chest radiographs and noncontrast ct of the chest. There is elevation of the left hemidiaphragm. No focal areas of consolidation are seen within the lungs. There is no pleural effusion or pneumothorax.
<unk>-year-old female shortness of breath. evaluation for cardiopulmonary process.
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There is a small left apical pneumothorax. Bilateral pleural effusions are nearly resolved. Pulmonary edema has improved. No focal consolidation. Heart size is top-normal. The aortic arch is heavily calcified. A left-sided port/central venous catheter terminates in the right atrium. A surgical clip projects over the left upper quadrant.
<unk> year old man with h/o aortic stenosis s/p tavr with bilateral pleural effusions s/p thoracentesis // eval for interval change s/p <unk>, r/o ptx
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As compared to the previous radiograph, the left chest tube is in unchanged position. There currently is no convincing evidence for pneumothorax. However, the overall volume and radiodensity of the left hemithorax have changed, with increasing density and slightly decrease in lung volume. Unchanged aspect of the cardiac silhouette. Unchanged appearance of the right hemithorax.
status post ebus, complicated by left pneumothorax, chest tube clamped. evaluation for pneumothorax.
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The lung volumes are exceedingly low, resulting in crowding of bronchovascular structures. Patchy opacity at the left lung base may reflect atelectasis or pneumonia. There is no pleural effusion or pneumothorax. Heart is normal size. Mediastinal hilar contours are unremarkable. Clips are seen overlying the thyroid bed.
fevers and cough. rule out pneumonia.
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The lungs are hyperinflated with severe emphysematous changes again noted at the lung apices. Left picc tip terminates in the svc. Heart size is normal. Mediastinal and hilar contours are unremarkable. New patchy bibasilar airspace opacities are demonstrated, more consolidative on the right. Small right pleural effusion is also likely present. No pulmonary edema is seen. There is no pneumothorax.
chronic copd with hemoptysis, epistaxis and desaturation.
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The left chest tube and pleural pigtail catheter are again present. Several of the pigtail catheter sideholes appear to be external to the pleural space and correlation is recommended. There is persisting and extensive subcutaneous emphysema along the left chest wall and neck. No discrete pneumothorax is identified. Since the prior exam the lucencies overlying the mediastinum or less conspicuous and attention on follow-up imaging is recommended. Unchanged platelike atelectasis in the right midlung zone and left lung base. The size the cardiac silhouette is within normal limits.
<unk> year old man with recurrent pneumothoraces s/p chest tubes, weaning suction // interval change? pneumothorax?
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Lungs are clear without focal consolidation, effusion, or edema. There is mild cardiac enlargement. No acute osseous abnormalities.
<unk>f with ?seizure, ams // r/o occult infection
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Single portable view of the chest. Minimal left basilar opacity is seen potentially due to atelectasis or prominent fat pad. The lungs are otherwise clear noting low lung volumes. Cardiac silhouette is slightly enlarged but likely accentuated by pa technique and low lung volumes. The cardiomediastinal silhouette is otherwise unremarkable. No acute osseous abnormality detected. Resorption of the distal right clavicle, potentially posttraumatic but old.
<unk>-year-old female with chest pain.
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Degree of cardiomegaly is unchanged from prior. Prosthetic valves and median sternotomy wires are again noted. There is hazy right basilar opacity which is new since prior, seen posteriorly on the lateral view. This could be a posteriorly loculated effusion versus focal parenchymal opacity. Elsewhere, lungs are clear. There is no overt pulmonary edema. No acute osseous abnormalities.
<unk>m with dyspnea on exertion, chest pressure // eval for acute process
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In comparison with the study of <unk>, the left chest tube has been removed. There is a small pneumothorax with subcutaneous gas along the lateral chest wall. Otherwise, little overall change except for some improvement in the opacification at the right base.
chest tube removal, to assess for pneumothorax.
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Right internal jugular central venous catheter tip terminates in the low svc. No pneumothorax is present. Lung volumes are low with patchy opacities in the lung bases most likely reflective of atelectasis. Heart size is top normal. The aorta is minimally tortuous. Hilar contours are unremarkable. Pulmonary vasculature demonstrates minimal engorgement without frank pulmonary edema. No focal consolidation or pleural effusion is demonstrated. There are no acute osseous abnormalities.
<unk>m s/p right central line placement
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Motion degradation on the lateral view limits assesment. The cardiomediastinal and hilar contours are unchanged with mild cardiomegaly. A left pacemaker defibrillator is present with tips terminating in the right atrium and right ventricle as expected. There are small bilateral pleural effusions and pulmonary vascular congestion, similar compared to the most recent prior study. There is no pneumothorax.
dyspnea, rule out chf.
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Single frontal view of the chest was obtained. Endotracheal and enteric tubes have been removed. The heart size is mildly enlarged. Cardiomediastinal contours are stable. Right lower lobe atelectasis is unchanged. No pleural effusion or pneumothorax.
<unk>-year-old male post-extubation.
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The patient is status post median sternotomy and left-sided pacemaker placement with leads terminating in right atrium, right ventricle, and coronary sinus. Moderate cardiomegaly is unchanged. Diffuse atherosclerotic calcifications of the aorta are again demonstrated. Mild pulmonary edema is similar compared to the previous exams. Small bilateral pleural effusions are present, with mild bibasilar atelectasis. No pneumothorax is identified. Degenerative changes in the thoracic spine are re- demonstrated.
weakness.
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Portable frontal radiograph of the chest demonstrates a left-sided pacemaker generator with single lead in the right atrium and <num> leads in the right ventricle. Normal heart size, mediastinal and hilar contours. No focal consolidation, pleural effusion or pneumothorax. Unchanged calcification of the aortic arch.
new rv lead, evaluate lead placement and pneumothorax.
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Bibasilar hazy interstitial opacities have increased since the exam yesterday at noon. Bilateral layering pleural effusions have increased. A left-sided picc line tip remains at the cavoatrial junction. Aortic arch calcifications are unchanged. Mild cardiomegaly is unchanged. No pneumothorax is present.
<unk>-year-old woman with tachypnea, evaluate for infiltrate.
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As compared to the previous radiograph, the patient has made a stronger inspiratory effort. The pre-existing parenchymal opacities in the perihilar right lung region have substantially decreased in extent. The areas of retrocardiac atelectasis are unchanged. No new parenchymal opacities. Unchanged size and shape of the cardiac silhouette.
cough, evaluation for pneumonia.
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There relatively low lung volumes. The cardiac silhouette remains markedly enlarged. The patient is status post median sternotomy and cardiac valve replacement. There is prominence of the central pulmonary vasculature suggesting mild pulmonary edema, somewhat is slightly increased as compared to the prior study. Subtle confluent opacity at the right lung base could relate to vascular congestion although an underlying consolidation is difficult to exclude. No pneumothorax is seen. There are scattered areas of linear atelectasis/scarring.
history: <unk>f with sob // acute process
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Assessment is limited by patient body habitus. Slight widening of the cardiomediastinal contours may be due to technique. There is no large pneumothorax or pleural effusion. Obscuration of the hemidiaphragms may reflect atelectasis. Mild vascular prominence may be due to technique and underpenetration or mild edema. Underlying consolidation is not excluded.
<unk>m with fever, sob at baseline.
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As compared to the previous examination, there is no relevant change. Moderate to severe right pleural effusion with unchanged distribution, better appreciated on the lateral than on the frontal radiograph. Minimal left pleural effusion. Subsequent areas of atelectasis at the right lung base is that are unchanged in extent. Unchanged moderate cardiomegaly, without current signs of overt pulmonary edema. The left lung appears unremarkable. There is no evidence of acute lung parenchymal disease such as pneumonia. The mediastinal contours are constant.
<unk>-year-old man with a chronic cirrhosis here for consideration, now with ambulatory desats. evaluation for infiltrate and edema.
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There is mild interstitial pulmonary edema and vascular congestion increased from the most recent prior study of <unk>. There is no focal consolidation. A small right pleural effusion is minimally increased. There is no definite left pleural effusion. Mild-to-moderate enlargement of the cardiac silhouette is stable in comparison to prior studies. The mediastinal contours are within normal limits. No pneumothorax is detected.
dyspnea, here to evaluate for pneumonia.
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There is moderate to moderately severe right convex scoliosis. The heart is not enlarged. There is no chf, focal infiltrate or effusion. No pneumothorax detected. Within the limits of plain film radiography, no hilar or mediastinal lymphadenopathy, pulmonary nodule, calcified granuloma, or apical infiltrate is identified. Apparent prominence of the left hilum is likely artifact due to the patient's scoliosis as no hilar enlargement is seen on the lateral view from the <unk> study and the frontal views are unchanged.
<unk> year old woman with h/o +ppd (untreated) <unk> week h/o cough and pleuritic cp with breathing. // is there evidence of pleuritis or other pulmonary disease?
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Frontal and lateral chest radiographs demonstrate minimal left basilar atelectasis. There is slight interval elevation of the left hemidiaphragm as a result. A granuloma is again noted in the left lung apex. There is no displaced fracture. The cardiac silhouette and mediastinal contours are normal. The pulmonary vasculature is normal. Pectus excavatum deformity is again seen. There is no pneumothorax.
<unk>-year-old male with rib pain after fall, question fracture.
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There is patchy bibasilar opacity, greater on the left than on the right. Superiorly, the lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified.
<unk>m with likely sepsis/infection // ? pneumonia
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A single portable ap semi-upright view of the chest was obtained. The endotracheal tube terminates approximately <num> cm above the carina with the patient's neck flexed and should be pulled back by approximately <num> cm for optimal placement. Ng tube is subdiaphragmatic. Heart is normal size and cardiomediastinal contours are unremarkable. Lung volumes are low and mild basilar atelectasis is noted. Lungs are otherwise clear. There is no pleural effusion or pneumothorax.
<unk>-year-old woman intubated, evaluate tube placement.
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As compared to the previous radiograph, the pre-existing pulmonary edema has decreased. The appearance of the lungs is back to the near normal status. Moderate cardiomegaly and absence of pleural effusions. The sternal wires are in correct alignment. No pneumothorax. No pneumonia.
altered mental status, pneumonia, evaluation.
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Portable upright view of the chest demonstrates low lung volumes, which accentuate bronchovascular markings. Bibasilar opacities most likely represent atelectasis. Hilar and mediastinal silhouettes are unchanged. Heart size top normal. There is no pulmonary edema. No pneumothorax. Descending aorta demonstrates heavy calcifications. Partially imaged upper abdomen is unremarkable.
assess for pneumonia.
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Pa and lateral views of the chest demonstrate well-expanded clear lungs. Heart is top normal in size and cardiomediastinal contour is unremarkable. There is no pleural effusion or pneumothorax.
<unk>-year-old man with hand infection, pre-op evaluation.
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The lungs are clear without focal consolidation, effusion, or edema. Calcific density again projects over the left lung base, likely a granuloma. The cardiomediastinal silhouette is stable. Thoracic s-shaped scoliosis is noted. No acute osseous abnormalities identified.
<unk>f with cdough, fever // presence of infiltrate, edema
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As compared to the chest radiograph from earlier the same day, left-sided pigtail catheter has been removed. A new left pleural catheter has been inserted, the tip not well seen. Interval decrease in the left pleural effusion which is now moderate. Improved atelectasis in the left lung. Mild interstitial pulmonary edema persists. Mild cardiomegaly.
<unk> year old man with left sided effusion s/p tpc placement // assess catheter placement
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Over <num> hours, there has been interval improvement in hazy right lower lobe opacity, which likely reflects improvement in atelectasis. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiac silhouette is normal in size, the mediastinal contours are normal.
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Ap portable upright view of the chest. A tracheostomy tube is unchanged in position. A left subclavian central venous catheter terminates at the lower svc. The lung volumes are low. The heart size is normal. The hilar and mediastinal contours are within normal limits. The central pulmonary vessels are engorged, however, there is no overt edema. There is no pneumothorax or pleural effusion. There is a new focal opacity within the right upper zone which may reflect aspiration or small consolidation.
<unk> year old man s/p mvc s/p trach and peg, ?aspiration event // look for evidence of aspiration
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Portable single ap chest radiograph was obtained with patient in upright position. There has been interval removal of the right chest tube with development of a small right apical pneumothorax. There is no mediastinal shift. At the left lung base opacity is unchanged, likely related to atelectasis. No pleural effusion or pulmonary edema is seen. Cardiomediastinal contour is within normal limits.
status post mitral valve replacement, chest tube removal, eval for pneumothorax.
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Heart size is mildly enlarged but unchanged. The mediastinal and hilar contours are similar. No focal consolidation, pleural effusion or pneumothorax is detected. Lungs remain hyperinflated with flattening of the diaphragms suggestive of underlying copd. Minimal linear opacities in the lung bases likely reflect areas of atelectasis. No acute osseous abnormalities visualized.
history: <unk>m with chest pain, malaise.
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There is a left lower lobe opacity, which most likely represents atelectasis, but infection should be considered in the appropriate clinical setting. No other consolidation. No effusion or pneumothorax. Cardiomediastinal and hilar contours are normal. No subdiaphragmatic air. No acute osseous abnormalities identified.
history: <unk>f with ugib, cough. // pneumonia?
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The cardiac, mediastinal and hilar contours are normal. The pulmonary vascularity is normal. There is minimal subsegmental atelectasis within the left mid lung field. Remainder of the lungs are clear. No pleural effusion or pneumothorax is visualized. No displaced rib fractures or other acute osseous abnormality is detected.
trauma, low oxygen saturation.
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Comparison is made to the previous study from <unk>. Heart size is prominent but stable. There is again seen coarsening of the bronchovascular markings, right side worse than left. Findings are suggestive of a chronic lung disease with areas of scarring. Underlying pulmonary edema would be difficult to exclude. There are no large pleural effusions.
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Pa and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.
<unk>f with cp x<num> days // eval for cardiomegaly
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Right apical opacity is compatible with known lung abscess, as seen on reference ct chest from <unk>. Diffuse hazy opacities in the remainder of the right lung, new since <unk>, are due to a pleural effusion of indeterminate size. The heart size is not enlarged. The left lung appears clear. No pneumothorax.
<unk> year old woman with ivdu, admitted for rul lung abscess, cellulitis, and mrsa bacteremia treated with vancomycin now with worsening chest pain and tachypnea. // ?pneumonia
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Pa and lateral chest views were obtained with patient in upright position. Available for comparison is the next preceding chest examination of <unk>. On the present examination, the heart size is within normal limits, and no configurational abnormalities are identified. The pulmonary vasculature is not congested. On the right lung base and located in the posterior segment of the right lower lobe, there is a discrete parenchymal density indicative of a pneumonic infiltrate. There is no pleural reaction and the right lateral as well as posterior pleural sinus is free from any fluid accumulation. The left lung base is unremarkable. On the frontal view, one can identify, in the right apical area, some scattered small parenchymal infiltrates overlying partially the proximal clavicular area and reaching the apical pleural space. The left apical area appears free, and no pneumothorax is present. Comparison with the next preceding chest examination of <unk> enables one to clearly identify the right lower lobe pneumonia as being new. Similarly, the right apical area was clean on the preceding examination. One can also see that there are some linear densities from the right hilum into the direction of the right apical area. The appearance of the lesion, although not typical, raised the possibility of specific tuberculous infection. Noteworthy is that on the preceding examination in <unk>, the heart size was considerably larger than it is now, although it might still have been within normal limits.
<unk>-year-old male patient with hiv, cd<num> at <num> of <unk>% six month ago. anxiety disorder, now newly on hiv treatment three times a week with atripla. several days fever as high as <num>, night sweats, dyspnea. right pectoral region discomfort, cough productive of yellow sputum. is there right-sided pneumonia? hilar lymphadenopathy? evidence <unk> <unk> or tb?
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Heart size is borderline enlarged. The aorta is tortuous. Mediastinal and hilar contours are otherwise unremarkable. The pulmonary vasculature is not engorged. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. Moderate degenerative changes are seen in the thoracic spine. Surgical anchor is noted in the left humeral head.
history: <unk>f with chest pain // ? infectious process
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Cardiac silhouette is mildly enlarged, more so than on <unk> with pulmonary vascular engorgement and interstitial edema superimposed on chronic pulmonary fibrosis. There is a left-sided pleural effusion along with left lower lobe consolidation as well as bilateral perihilar consolidations worrisome for pneumonia. There is no pneumothorax.
dyspnea.
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There is bibasilar opacity, left worse than right. The hilar and mediastinal silhouette are stable without evidence of pulmonary edema. The heart size stably mildly enlarged. There is no pleural effusion or pneumothorax. Patient is status post median sternotomy with wires aligned and intact.
history: <unk>m with cp // pna?
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Pa and lateral views of the chest demonstrate the lungs are well expanded and clear. The cardiomediastinal silhouette is unremarkable. There is no pleural effusion, pulmonary edema, pneumothorax or focal consolidation concerning for pneumonia.
<unk>-year-old male with fever for <num> days of unknown source. evaluation for effusion or infiltrate.
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Frontal and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Partially imaged is hardware at the left glenohumeral joint in the region of the left humeral head, not well evaluated. No displaced rib fracture is seen, although rib series is more sensitive.
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There has been interval intubation with the endotracheal tube tip terminating approximately <num> cm from the carina. An enteric tube tip appears to be within the stomach. Heart size is normal. The mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. Worsening streaky opacities in the lung bases bilaterally most likely reflect increased atelectasis, although aspiration remains a concern. No pleural effusion or pneumothorax is seen. There is continued elevation of the right hemidiaphragm.
history: <unk>f with overdose // confirmation of ett placement
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The cardiac silhouette is normal in size. The hilar and mediastinal contours are within normal limits. Lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. There is a <num> mm rounded density in the a right upper lobe.
history: <unk>m with sob // eval for ptx
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The lungs are well expanded. The right lung is clear. Linear opacity across the left lower lung field likely represents scarring vs atelectasis. There is moderate cardiomegaly and equivocal bulky hila, but the cardiomediastinal and hilar contours are unchanged from prior. There is no pleural effusion or pneumothorax. Sternotomy wires are noted in the midline and there are no other fractures.
a <unk>-year-old male with shortness of breath on exertion and a history of cabg. evaluate for evidence of pneumonia or chf.
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In comparison with the study of <unk>, there is again substantial hyperexpansion of the lungs with flattening of the hemidiaphragms, consistent with chronic pulmonary disease. Cardiac silhouette is within normal limits, and there is mild aortic tortuosity. Probable calcification in the right mid zone, consistent with granuloma. No acute focal pneumonia. The pleural-based opacification laterally at the lower left is unchanged since at least <unk>.
shortness of breath.
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Lung volumes are diminished. No consolidation or edema is noted. The mediastinum is unremarkable. The cardiac silhouette is within normal limits for size. No effusion or pneumothorax is noted. The visualized osseous structures are unremarkable.
hypertension and presyncope.
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Left picc has been re-positioned, with the tip now in the proximal superior vena cava and apparently abutting the lateral wall of the structure. Other devices are similar in position. Cardiomediastinal contours are unchanged. Lungs are clear except for minor atelectasis at the lung bases.
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The lungs are clear. The heart size is normal. The mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen.
facial droop with episodes of blacking out. evaluate for acute intrathoracic process.
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In comparison with the study of <unk>, the monitoring and support devices are unchanged. Continued pulmonary vascular congestion with poor definition of the right hemidiaphragm consistent with layering effusion and volume loss in the lower lobe. Some atelectatic changes are also seen at the left base.
ards.
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The heart is mildly enlarged, unchanged from prior. Lungs are well-expanded and clear. Hilar contours are within normal limits. No pneumothorax, pleural effusion, or consolidation.
history: <unk>m with sickle cell p/w diffuse pain // ?focal consolidations
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Ap upright and lateral views of the chest provided. The lungs are hyperinflated. There is no focal consolidation, effusion, or pneumothorax. There is mild interstitial edema. Heart size is top-normal. Imaged osseous structures are intact. There is dextroscoliosis of the thoracic spine. No free air below the right hemidiaphragm is seen.
history: <unk>f with pericarditis // ? effusion, consolidation
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Right picc continues to terminate in the lower superior vena cava. Right internal jugular vascular catheter has been removed, with no evidence of pneumothorax. There is otherwise no substantial short-interval change in the appearance of the chest since the recent study of earlier the same date.
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Pa and lateral radiographs of the chest demonstrate moderate pulmonary edema as well as moderate cardiomegaly which is worse than on the prior chest radiograph from <unk>. There are small to moderate bilateral pleural effusions. There is no pneumothorax.
<unk>-year-old woman with chest pain. evaluate for volume overload.
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The heart is moderately enlarged. The upper mediastinal contours are stable with a right aortic arch. There is minimal bibasilar atelectasis but no focal consolidation, pleural effusion, or pneumothorax. No evidence of congestive failure.
history: <unk>f with l chest warmth/tightness // eval cardiomegaly, effusion, infiltrate
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Cardiac silhouette is normal in size. Patchy opacities are present at both lung bases medially, with overall interval decrease in extent compared to the prior radiograph. This may represent resolving atelectasis, recurrent aspiration or resolving infection. No new areas of consolidation are identified elsewhere in the lungs, and there is no definite pleural effusion or pneumothorax.
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There are low lung volumes. The heart size is mildly enlarged with a left ventricular predominance, unchanged. The aortic knob is calcified. Mediastinal and hilar contours are unchanged. Streaky opacities in the lung bases likely reflect atelectasis. Small bilateral pleural effusions are likely present. No pulmonary edema or pneumothorax is present. Compression deformity at the thoracolumbar junction is re- demonstrated.
fluid about the spine.
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The endotracheal tube has been withdrawn, with tip lying approximately <num> cm from the carina. An enteric tube is new in the interval with tip in the stomach. Right internal jugular central venous catheter has been placed in the interval with tip in the proximal right atrium. No pneumothorax is demonstrated. Remainder of the examination appears relatively unchanged. There is continued mild pulmonary edema with small bilateral pleural effusions. Bibasilar atelectasis/collapse is present though infection cannot be excluded.
history: <unk>m with central line placement
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The heart size is normal. The hilar and mediastinal contours are unremarkable. The left pectoral pacemaker leads end in the right atrium and right ventricle, in appropriate position. The sternal wires are intact and clips from prior cabg are noted. There is no pulmonary vascular congestion. No focal consolidations concerning for infection, pleural effusions or pneumothoraces are identified. There is mild bibasilar atelectasis. Visualized osseous structures are unremarkable.
history of low-grade temperatures. please evaluate for infectious process.
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Stable cardiomegaly accompanied by pulmonary vascular congestion. Worsening bibasilar opacities, left greater than right, which could reflect aspiration or developing infectious pneumonia in the appropriate clinical setting. Small pleural effusions are also demonstrated. Known skeletal metastases and healed rib fractures are similar to recent radiograph. Subcutaneous emphysema is present the right chest wall.
<unk> year old man with prostate ca on leupron with bony lesions on denosumab now presenting after fall with chills/rigors. // consolidation/pneumonia
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Single ap upright portable view of the chest was obtained. The cardiac silhouette is enlarged due to cardiomyopathy and/or pericardial effusion. Patient is status post median sternotomy. A dual-lead left-sided pacer device is seen. The distal aspect of the leads are not seen due to underpenetration at the lower hemithorax. The hemidiaphragms are partially obscured but could relate to underpenetration, although there may also be a right-sided pleural effusion with underlying atelectasis, underlying consolidation cannot be excluded. There is mild prominence of the central pulmonary vasculature which could in part relate to low lung volumes. No pneumothorax is seen.
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Moderate cardiomegaly is unchanged. Mediastinal and hilar contours are unchanged. Pulmonary vasculature is not engorged. Patchy opacity in the right lower lobe is without substantial interval change from the previous examination. A trace right pleural effusion appears minimally increased from the prior study. Left lung is clear. No pneumothorax is present. There are no acute osseous abnormalities.
history: <unk>m with recurrent abdominal pain, today with distension, chest pain and shortness of breath
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There has been interval removal of the right-sided chest tube with residual trace right chest wall subcutaneous emphysema. No pneumothorax. Right internal jugular central venous catheter is unchanged terminating at the cavoatrial junction. Bibasilar atelectasis is increased from <unk>. Left lower lobe opacity is increased from <unk> at <time> with similar appearance to <unk>:<num>. Mild pulmonary edema is increased from <unk>.
<unk>m w dmii, htn, pad s/p mcc w t<num> facet fx; aortic pseudoaneurysm/ dissection s/p tevar; r hemothorax s/p ct; r<num>, l<num>-<unk>, <unk> rib fx; l grade <num> renal lac; r fem neck/trochanteric fx s/p dhs. dc'ed chest tube // ? pneumoplease do at midnight
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In comparison with study of <unk>, the tip of the picc line is in the lower svc just above the cavoatrial junction. There is slightly lower lung volume. This may account for the apparent crowding of vessels at the bases, though some atelectatic change would have to be considered.
abdominal pain, for picc placement.
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Heart size is normal. Cardiomediastinal contour is unchanged. There is mild prominence of the central pulmonary vasculature and re- demonstration of mildly increased reticulation with some fluid seen tracking along the right major fissure. There is no dense consolidation. Pleural surfaces are clear without effusion or pneumothorax.
cough, fever and left-sided chest/ flank pain, progressively worse over the past <num> days.
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Portable ap chest radiograph demonstrates no focal consolidation, pleural effusion or pneumothorax. The heart size may be mildly enlarged. There is no evidence of overt pulmonary edema. There are no acute skeletal abnormalities.
<unk>-year-old man with hypertension and dyslipidemia, coronary stenting. evaluated for cabg preop; surgery is on <unk>.
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There is been interval development of bilateral lower lobe predominant airspace opacities with cephalization likely representing pulmonary edema and vascular congestion. Overall the appearance is unchanged from <unk>. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is stable. Imaged upper abdomen is unremarkable.
<unk> year old man with decompensated cirrhosis. eval for infiltrate, fluid.
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Pa and lateral views of the chest are compared to previous exam from <unk>. A subtle increased opacity projecting over the heart on the lateral view which is not corroborated on the frontal and may be due to atelectasis. Elsewhere, lungs are clear. Cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable.
<unk>-year-old female with cough.
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Pa and lateral views of the chest demonstrate the heart is mildly enlarged, but stable compared to prior exams. Aortic knob and lad calcifications/stent are again noted. Subsegmental atelectasis in the left mid lung and lung base are unchanged. Right apical scarring is again noted. Otherwise, the lungs are clear with no evidence of pleural effusion, pulmonary edema or focal consolidation concerning for pneumonia.
<unk>-year-old female with palpitations. evaluate for acute process.
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As compared to the previous radiograph, the tip of the swan-ganz catheter is unchanged within one lower lobe segmental pulmonary artery. The other lines and tubes are stable. No evidence of complications. Significantly worsened bilateral widespread opacities, combined to small-to-moderate pleural effusions.
recently adjusted pulmonary artery catheter.
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There is a new right ij central line with tip in the distal svc. There continues to be moderate cardiomegaly with pulmonary vascular redistribution, without focal infiltrate or effusion. Sternotomy wires are again seen. There is no pneumothorax.
right ij central line.
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Frontal and lateral views of the chest were obtained. There is no focal consolidation, pleural effusion, or pneumothorax. Pulmonary vasculature is normal without evidence of pulmonary edema. Heart size is normal. Mediastinal silhouette and hilar contours are normal. A <num>cm rounded density in the posterior right upper abdomen is a kidney stone seen on ct <unk>, and is probably larger than on <unk>, but similar to <unk>.
<unk>-year-old woman with dyspnea and lower extremity edema. evaluate for vascular congestion.
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The examination is limited due to is placement of the patient's arms across the lower chest, obscuring detail of the lower mediastinum and lung bases as well as the pleura and ribs in this region. Heart size and mediastinal contours are within normal limits, and lungs are grossly clear. Minimal blunting of left costophrenic sulcus posteriorly could reflect pleural thickening or small effusion. Mild compression deformities at the thoracolumbar junction on the lateral radiograph rib indeterminate age without older studies for comparison. No acute, displaced rib fractures are evident on this limited assessment. .
<unk> year old woman struck by car // ?injury
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The pacemaker is in unchanged position. Bilateral mid to lower lung opacities, right more than left, have worsened. Bilateral pleural effusion with associated volume loss has increased. Superimposed pneumonia in the right hemithorax cannot be ruled out, especially without lateral view. Severe cardiomegaly is unchanged. Mediastinal silhouette is unchanged.
<unk> year old man with dyspnea, tachypnea // new pna? effusion interval change?
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Frontal chest radiographs demonstrate a nasogastric tube with the tip in the stomach. Bilateral pleural effusions are increased, left greater than right. Severe cardiomegaly and bibasilar atelectasis is unchanged
status post dobbhoff placement.
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Persistent cardiomegaly accompanied by pulmonary vascular congestion. Moderate-to-large right pleural effusion has increased in size, but a small-to-moderate left pleural effusion appears slightly decreased. Adjacent areas of atelectasis are present in both lower lobes. Additionally, there is a questionable area of new consolidation in the right mid lung region, somewhat difficult to differentiate from the adjacent pleural effusion. Attention to this region on a short-term followup radiograph would be helpful to exclude an acute pulmonary process such as aspiration or a developing pneumonia in this region.
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Cardiac silhouette size remains mildly enlarged. The aorta is tortuous and the ascending aortic contour appears dilated, but unchanged. Pulmonary vasculature is not engorged. No focal consolidation, pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. Hypertrophic changes are again seen in the thoracic spine.
history: <unk>m with fever
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The cardiomediastinal and hilar contours are normal. The lungs are clear. There is no pleural effusion or pneumothorax.
<unk>-year-old male with persistent chest congestion and cough for three weeks.
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The heart is normal in size. Thoracic aorta is mildly tortuous with calcifications seen in the arch. Lungs are well expanded and clear. No pleural effusions and no pneumothorax.
<unk>-year-old woman with new hypoxia, rule out pneumonia/effusion.
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Patient is status post median sternotomy and cabg. Left-sided pacemaker device is noted with leads terminating in the right atrium right ventricle. Mild enlargement of the cardiac silhouette is re- demonstrated. The aorta is diffusely calcified and tortuous, unchanged. Moderate pulmonary edema is new in the interval. No pleural effusion or pneumothorax is present. Osseous structures are diffusely demineralized with mild to moderate multilevel degenerative changes.
history: <unk>f with worsening shortness of breath // ?infectious process
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Endotracheal tube terminates approximately <num> cm above the carina. The lungs are relatively hyperinflated. Subtle left base patchy retrocardiac opacity may be due to atelectasis or aspiration, less likely infection. No pleural effusion or pneumothorax is seen. The cardiac silhouette is top-normal. Mediastinal contours are unremarkable.
history: <unk>f with s/p intubation // ett placement
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Frontal and 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.
<unk>-year-old male with fever cough. assess for pneumonia.
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An endotracheal tube is in satisfactory position <num> cm from the carina. A ight internal jugular catheter is present with the tip near the atriocaval junction. The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The mediastinal contours are widened due to the known large pseudoaneurysm, which is better characterized on the recent ct. The heart is severely enlarged. Sternal wires are intact.
evaluate endotracheal tube and internal jugular central venous catheter.
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There is a three-lead pacemaker/icd device with leads terminating in the right atrium, right ventricle, and coronary sinus, respectively. The heart appears moderately enlarged. The aorta is calcified. There is no pleural effusion or pneumothorax. The interstitium is mildly hazy appearance suggesting mild vascular congestion. Fissures are mildly thickened. The bones are probably demineralized.
right-sided chest pain.
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Median sternotomy sutures and a mitral valve prosthesis, unchanged in appearance compared to the prior study. Moderate cardiomegaly and pulmonary edema are similar in degree when compared to the prior study. Probable right pleural effusion. No pneumothorax seen.
<unk> year old woman redo mvr // eval for effusion
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Previously seen right pleural effusion may be slightly decreased in size. The right lateral pleural thickening is unchanged. The left lung is clear. No evidence of pneumonia. Cardiac size is normal. No mediastinal widening. No pneumothorax.
lung cancer, on chemotherapy, productive cough for one week, evaluate for pneumonia.
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There is no focal consolidation or pleural effusion. Elevation of the left hemidiaphragm is stable. Linear opacities at the right base are either atelectasis or scarring. The upper lung zones are clear. There is mild enlargement of the cardiac silhouette. Median sternotomy wires are present and intact. Again seen are calcified pleural plaques in the periphery of the left hemithorax.
<unk>-year-old man with hypotension, evaluate for pneumonia.
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Lung volumes are lower, which accentuates the bronchovascular structures. Persistent opacification of the left lung base, either atelectasis or aspiration. There may be a small left pleural effusion. There is no pneumothorax or definite pleural effusion. Cardiac and mediastinal contours are unchanged and normal. Endotracheal tube is in satisfactory position, <num> cm above the carina. A right internal jugular catheter and enteric tube are proper.
recent stroke and aspiration event now intubated. evaluate et tube.
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In comparison with the earlier study of this date, the enteric tube has been pulled back slightly, so that the side hole is apparently above the esophagogastric junction. The tube should be pushed forward several centimeters. The other monitoring and support devices are within normal limits. Again, there are large layering pleural effusions with substantial pulmonary edema. In the appropriate clinical setting, supervening pneumonia would have to be considered.
hepatic encephalopathy, to assess for pulmonary edema.