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The heart is again mildly enlarged. The mediastinal and hilar contours appear unchanged. Streaky opacities in the medial lower lung suggests minor atelectasis. Although the posterior costophrenic sulci are partly excluded, a meniscoid appearance to the posterior right lower hemithorax suggests a very small pleural effusion or thickening, but appears unchanged. Slight nodular thickening along the minor fissure is also unchanged. The osseous structures are unremarkable.
near syncope. question pneumonia.
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Compared with prior radiographs performed on same day on <unk> at <time>, there has been interval placement of bilateral chest tubes, with decrease in bilateral pleural effusions and increased aeration of the bilateral lungs. An et tube terminates approximately <num> cm above the carina. An ng tube passes below the level of the diaphragm and into the stomach. Again seen is pneumomediastinum, and subcutaneous air in the neck and lateral chest wall. There is no focal consolidation or pneumothorax.
<unk> year old woman s/p esophageal perforation repair. bilateral chest tube. // eval for b/l chest tubes, effusions, ngt placement
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As compared to the previous radiograph, the previously malpositioned dobbhoff catheter has been re-positioned. The catheter is now located in the stomach. However, the device is coiled, with the tip pointing towards the gastroesophageal junction. Further advancement by approximately <num> cm might be helpful. No complications. The right picc line is in unchanged position. Unchanged borderline size of the cardiac silhouette and minimal pulmonary fluid overload.
dobbhoff placement and repositioning.
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The left port-a-cath tip terminates in cavoatrial junction. The pleurx tube is in unchanged position. The previously seen right pneumothorax has resolved. The right pleural effusion has decreased in size. Mild atelectasis is present in the right lower lung. The remaining right lung and left lung are clear. Multiple masses and nodules in both left and right lung are unchanged.
<unk> year old woman with pleural effusion // eval
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Ap upright and lateral views of the chest were provided. Low lung volumes noted. Lungs appear clear. No signs of pneumonia or chf. Cardiomediastinal silhouette is normal. Bony structures are intact.
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Hyperinflated lungs with flattened diaphragms and widened ap diameter are consistent with known copd. Lungs clear bilaterally, without pleural effusion or pneumothorax. Heart size is mildly enlarged with mild left ventricular and right ventricular enlargement with prominent hila. Two anterior compression fractures with moderate loss of height in the thoracic spine without additional bony abnormality.
female with copd.
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The cardiac, mediastinal, and hilar contours appear unchanged. The heart is again enlarged but difficult to assess, owing to low lung volumes. Small bilateral pleural effusions are present, more conspicuous on the right, and there is mild-to-moderate but worsening interstitial process compared to the prior study including indistinctness of pulmonary vessels. The appearance is most consistent with pulmonary vascular congestion.
shortness of breath.
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There has been an increase in the left pleural effusion, limiting assessment of the cardiac size. There is interval decrease in the right pleural effusion, now small, with right basilar atelectasis. Interstitial markings have slightly increased, indicating mild interstitial edema. The right apical pneumothorax is decreased in size, now <num> mm. Prominence of the main pulmonary artery is stable. Right port is present with tip in unchanged position.
moderate apical pneumothorax.
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Lung volumes are slightly low although the lungs are clear. Heart size is top normal. The mediastinal contours are normal. There are no pleural abnormalities. The patient is status post midline sternotomy and cabg. Degenerative changes of the thoracic spine are noted.
seizures, evaluate for pneumonia.
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Comparison is made to previous study from <unk>. The patient has been extubated. The lungs are grossly clear, with improvement in pulmonary vascular congestion since the previous study. There is no focal consolidation. Heart size is within normal limits. The vascular pedicle is normal.
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The exam is suboptimal due to underpenetration from patient body habitus. Enlarged cardiomediastinal silhouette is again seen, which is likely due to mediastinal lipomatosis. Evaluation of the lung bases, particularly on the left, is suboptimal due to underpenetration and a small focal consolidation is difficult to exclude. No large pneumothorax. No definite pleural effusion, although small pleural effusion would be difficult to exclude. There are low lung volumes with possible mild vascular congestion with vascular structures appearing similar to prior.
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Comparison is made to previous study from <unk>. There has been removal of a pigtail catheter on the left side. There are no pneumothoraces seen on either side. There are slight bullous changes seen in the lung apices. Heart size is normal. There are no pleural effusions or focal consolidation. Bony structures are intact.
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There are low lung volumes. The cardiac silhouette size is unchanged, and borderline enlarged. The aortic knob is calcified. The mediastinal and hilar contours are unremarkable otherwise. There is no pulmonary edema. Streaky opacities in the lung bases likely reflect atelectasis. No pleural effusion or pneumothorax is detected. There are multilevel degenerative changes in the thoracic spine. Numerous clips are demonstrated within the left upper abdomen. No free air is identified under the diaphragms.
epigastric abdominal pain and history of rectal cancer status post ostomy.
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Dual lead left-sided pacemaker is seen with leads extending to the expected positions of the right atrium and right ventricle.no focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac silhouette is mildly enlarged. Mediastinal contours are unremarkable. There may be minimal central pulmonary vascular engorgement without overt pulmonary edema.
history: <unk>f with palpitations // ?pna
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The patient is status post decortication with a slight interval increase in moderate right-sided pneumothorax. Two chest tubes are in place overall unchanged in position. There is moderate subcutaneous emphysema. Along the right lower lobe, there is collapsed lung parenchyma, overall similar to prior exam. Moderate cardiomegaly persists. Platelike atelectasis at the left lung base is similar to the prior exam. Small bilateral effusions are persistent. There is a left-sided pacer with leads in stable position.
history of right decortication postop day #<num>. please evaluate.
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There is no change in the cardiomegaly and central pulmonary vascular congestion but there appears to be less interstitial prominence likely reflecting resolution of interstitial edema. Small bilateral pleural effusions seen on recent ct are not well appreciated on this study. Left pulse generator with electrodes within the right atrium, right ventricle, and coronary sinus is in expected and unaltered position. Mitral and tricuspid valve replacements are again noted. Sternal wires are intact.
<unk> year old woman with heart failure, pulmonary edema, bilateral pleural effusions // <unk> year old woman with heart failure, pulmonary edema, bilateral pleural effusions
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Left-sided pacemaker is noted with leads terminating in expected positions of the right atrium and right ventricle. There are small bilateral pleural effusions. There is no pneumothorax. The lungs are otherwise clear. The cardiac, mediastinal and hilar contours are stable.
<unk>-year-old status post dual-chamber pacemaker placement.
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Pa and lateral views of the chest. The lungs are clear. There is no consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. No acute osseous abnormality is detected.
<unk>-year-old male with chest pressure and shortness of breath.
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Heart size is top normal. The mediastinal silhouette and hilar contours are stable. The lungs are clear without focal consolidation, pneumothorax or effusion. No acute bony abnormality is identified.
cough, fever and tachycardia.
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A pigtail projects in the lower peripheral left hemithorax. There has been reaccumulation of a mild-to-moderate pleural effusion on that side. There is no change in the right lung where there is fibroatelectasis due to prior radiation in this patient that was treated for a lymphoma. The right moderate-to-important pleural effusion with compressive atelectasis has not changed. The mediastinal and cardiac contours are stable. Chronic calcified mediastinal lymph node and degenerative change of the shoulders. The right port-a-cath is in unchanged position. There is no pneumothorax.
patient with prior history of lymphoma, breast cancer, thyroid cancer, ovarian cancer with pleural effusion drained yesterday. rule out pleural reaccumulation.
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<num> views were obtained of the chest. The lungs are low in volume with persistent elevation of right hemidiaphragm resulting in mild right basilar atelectasis. There is no focal consolidation, pleural effusion or pneumothorax. The heart is top-normal in size with normal cardiomediastinal contours. Sternotomy wires appear intact with post cabg changes noted.
dka, assess for pneumonia.
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As compared to the previous radiograph, the swan-ganz catheter has been pulled back. Otherwise, the monitoring and support devices are in unchanged position. Unchanged size of the cardiac silhouette. Unchanged bilateral parenchymal opacities at the lung bases. On today's radiograph, the presence of small pleural effusions cannot be excluded. Unchanged appearance of the mediastinum, no mediastinal widening.
aaa repair, splenectomy, evaluation for atelectasis.
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The cardiac, mediastinal and hilar contours appear unchanged. Mild subpleural scarring is unchanged at each lung apex. Although there is no pleural effusion on the right, there is a new small pleural effusion on the left since four days earlier. Patchy associated opacity in the retrocardiac area is streaky, possibly atelectasis.
sepsis. question pneumonia.
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Since <unk>, there is interval decrease in the left pleural effusion. The port-a-cath ends at the low svc near the cavoatrial junction. Right sided chest tube is visualized. Ng tube is removed since <unk>. Cardiomediastinal borders and hilar structures are unchanged mediastinal air-fluid level related to recent esophagectomy. There is no pneumothorax.
<unk> year old man s/p mie // r/o ptx post ct removal
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As compared to the previous radiograph, there is no relevant change. The pre-described right mid lung pneumonia, the bilateral basal areas of scarring are constant. Also constant is the normal size of the cardiac silhouette as well as the mildly enlarged bilateral hilar structures, suggesting enlarged pulmonary arteries and pulmonary hypertension. No new parenchymal opacities. No pleural effusions. Unchanged rightward tracheal deviation, likely caused by an enlarged thyroid.
copd, exacerbation, rule out pneumonia.
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There are vertically oriented chain sutures along the superior aspect of the right lung compatible with prior surgery. No evidence of pneumothorax. The lungs are clear and the cardiomediastinal silhouette is normal. No pleural effusion.
<unk>m with right-sided chest pain and history of pneumothorax. evaluate for pneumothorax.
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There is moderate cardiomegaly. There is mild pulmonary vascular congestion without overt edema, effusion, or consolidation. Osseous structures are unremarkable. There is no definite focal consolidation.
<unk>m with sob // ? pul edema
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Chest pa and lateral radiograph demonstrates unremarkable mediastinal, hilar and cardiac contours. Lungs are clear. No pleural effusion or pneumothorax evident.
shortness of breath for two weeks, please for evaluate for cardiopulmonary process.
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As compared to the previous radiograph, the lung volumes have decreased. The opacities in the left lung have substantially increased, showing a consolidative component in the lung periphery that was not visible on the previous exam. The opacities in the right upper lung have also increased in severity and extent. Size of the cardiac silhouette remains constant. Constant position of the vascular stent projecting over the right aspects of the mediastinum. At the time of dictation and observation, <time> a.m., on <unk>, the referring physician, <unk>. <unk>, covered by dr. <unk>, was paged for notification.
pneumonia with worsening dyspnea, evaluation for changes.
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The lungs are hyperinflated. There is persistent small left-sided pleural effusion. Prior right effusion is no longer visualized. Left-sided volume loss is compatible with prior left upper lobectomy. The lungs are hyperinflated but clear of consolidation or pulmonary edema. The cardiomediastinal silhouette is within normal limits. Aortic corevalve again noted as well as atherosclerotic calcifications at the aortic arch. No acute osseous abnormalities.
<unk>f with cough // ?pna
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Two views of the chest demonstrate unchanged sternal wires and an aortic valve prosthesis. The mediastinum is normal in contour. The heart is top-normal in size, unchanged compared to <unk>. There is minimal, if any, central vascular congestion without frank pulmonary edema. No focal consolidation, pleural effusion, or pneumothorax is seen. The visualized upper abdomen is unremarkable.
evaluate for pneumonia in an <unk>-year-old female with altered mental status.
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As compared to the previous radiograph, the distribution of the known right pleural effusion is slightly different, but the overall extent is unchanged. Unchanged limited accessibility of the image, given the patient position. Unchanged large hiatal hernia and large right apical mass. No change in appearance of the visible lung parenchyma on the left.
lung cancer, chest tube, evaluation for effusion.
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Ap and lateral views of the chest. There are densely calcified bilateral pleural plaques. This limits detailed evaluation of the underlying lung parenchyma. Increased opacity at the left lung base is compatible with pleural effusion, not definitely changed since the recent ct scan given differences in technique. Increased opacity projecting over the right lung base is likely due to superimposed calcified plaque noting the underlying parenchymal opacity would be difficult to exclude. The cardiomediastinal silhouette is stable. No acute osseous abnormalities detected.
<unk>-year-old male with history of effusion with shortness of breath.
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Pa and lateral views of the chest demonstrate slightly lower lung volumes compared to the prior study with minimal left basilar atelectasis. The cardiomediastinal silhouette is unremarkable and there is no evidence of pneumothorax, pulmonary edema or pleural effusion. No focal opacification is identified within the lungs bilaterally.
chest pain and back pain.
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Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.
history: <unk>f with cough, shortness of breath
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Pa and lateral views of the chest were provided. The lungs appear clear, with hyperinflation and upper lobe pleural parenchymal scarring. No effusion or pneumothorax is seen. The heart size remains normal. Thoracic aortic atherosclerotic calcification again noted. Bones appear intact. Clips are noted in the mid abdomen.
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Pa and lateral views of the chest. The lungs are clear without consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is identified.
<unk>-year-old female with sudden onset of left-sided chest pain.
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Single ap upright portable chest radiograph obtained. The lungs are clear. Cardiomediastinal silhouette is stable with prominence of the superior mediastinum which is attributable to tortuous mediastinal vessels as seen on prior mr <unk> and stable from prior chest radiographs dating back to <unk>. Bony structures are intact.
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Ap chest radiograph. There is slight worsening opacification in the right mid lung consistent with pneumonia in the background setting of known multifocal bronchioalveolar carcinoma. The cardiomediastinal silhouette is stable. There is no pulmonary vascular engorgement, large pleural effusion, or pneumothorax.
neutropenia and hypoxia. evaluate for bibasilar pneumonia and history of bronchioalveolar carcinoma. evaluation for interval change.
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In comparison with study of <unk>, there is some further decrease in opacification in the right upper zone. Cardiac silhouette is at the upper limits of normal in size. No definite vascular congestion or pleural effusion. Of incidental note are surgical clips seen adjacent to the lower left chest wall.
ms with respiratory insufficiency.
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Since the prior radiograph, the endotracheal tube, central line, and feeding tube have been removed. Moderate bilateral effusions, slightly larger on the right than the left, have decreased in size. There is no new consolidation or edema. There is no pneumothorax. Moderate enlargement of the cardiac silhouette is stable.
end-stage renal disease and somnolence with new o<num> requirement.
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Single portable semi upright frontal chest radiograph demonstrates moderately well expanded and clear lungs with bibasilar atelectasis. Right middle lobe opacity with preservation of the diaphragm and heart borders is most consistent with epicardial fat. No pleural effusion or pneumothorax. Mild cardiomegaly is likely accentuated due to patient positioning. Mediastinal contour and hila are otherwise unremarkable. Limited assessment of the upper abdomen is within normal limits.
<unk> year female with nstemi. assess for acute process.
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Pa and lateral views of the chest provided. Spinal stabilization hardware is noted in the lower cervical spine. The lungs are clear. Cardiomediastinal silhouette is normal. Bony structures intact.
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Right picc line terminates in the upper to mdi svc. No pneumothorax. Lung volumes are low. There is no consolidation, effusion or pulmonary edema. Mediastinal and hilar contours are normal. Mild cardiomegaly is unchanged.
<unk> year old woman with pyelonephritis, picc placed for iv antibiotics and now coming out. please asses it is in correct place // ?picc in place
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In comparison with study of <unk>, there is little overall change. Again there is substantial enlargement of the cardiac silhouette with evidence of pulmonary vascular congestion. The hemidiaphragms are not sharply seen, most likely reflecting some pleural effusion and bibasilar opacifications. Tracheostomy tube remains in place.
tracheostomy with continued fluid overload.
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Portable semi upright radiograph of the chest demonstrates low lung volumes which results in bronchovascular crowding. There is a small left-sided pleural effusion with adjacent atelectasis. The cardiomediastinal and hilar contours are unchanged. The lower aspect of the right hilus appears enlarged, as before. There is no pneumothorax or evidence of focal consolidation.
<unk> year old woman with delirium.
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Tip of right internal jugular central venous catheter terminates in the region of the cavoatrial junction. Other indwelling devices are in standard position, and cardiomediastinal contours are stable allowing for patient's rotation. Pulmonary vascular congestion is present. Bibasilar opacities are again demonstrated, with interval worsening in the left retrocardiac region, and slight improvement in the right lower lobe, with improved visualization of the right hemidiaphragm. Bilateral small-to-moderate pleural effusions are also demonstrated, but there is no visible pneumothorax.
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Nodular opacities seen on <unk> are little changed. Post-surgical changes from prior right upper lobe wedge resection are noted. There is no focal consolidation, pleural effusion or pneumothorax. The heart size is normal.
history of sarcoidosis and cough, currently being tapered on prednisone. assessment for interval change.
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Comparison is made to previous study from <unk>. There is again seen a right pigtail catheter. There are no pneumothoraces. There is a right-sided pleural effusion and some consolidation in the right base, unchanged. Low lung volumes are present. The right lung is relatively well aerated. Heart size is upper limits of normal.
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The cardiomediastinal and hilar contours are within normal limits. Lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax. Again seen is rightward deviation of the trachea, likely reflective of known enlarged thyroid gland.
history: <unk>f with cough and congestion // evaluate for pneumonia evaluate for pneumonia
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As compared to the previous radiograph, there is slightly increased bilateral lung volume, likely reflecting either improved ventilation or increased respiratory pressure. The signs suggesting pulmonary edema are improved, but mild edema is still present. No pneumothorax. Unchanged size of the cardiac silhouette. Unchanged bilateral pleural effusions.
endocarditis, persistent depressed level of consciousness, evaluation.
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Ap semi upright view of the chest provided. There is no focal consolidation, effusion, or pneumothorax. Bibasilar atelectasis is similar to prior. Mild cardiomegaly and large hiatal hernia are similar to prior. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.
history: <unk>f with fall from standing. reports headache, neck pain, tspine ttp, right shoulder ttp // eval for ich, spinal fracture, shoulder fracture/fracture
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There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. Lungs are well-expanded and clear. The cardiomediastinal contour is normal.
<unk>m with chest pain, evaluate for pneumonia.
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The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. There are upper lobe predominant reticular and nodular opacities with upper lobe volume loss. There is bilateral hilar lymphadenopathy and possible on mediastinal lymphadenopathy in the ap window. There is no pleural effusion or pneumothorax.
history: <unk>f with fever, cough // eval for consolidation
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The heart is borderline enlarged, in the mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are not hyperinflated, and there is no focal consolidation concerning for pneumonia. A right chest port is present with tip terminating near the cavoatrial junction. The upper abdomen is unremarkable in appearance.
<unk> year old man with ?copd and fever // r/o consolidation
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When compared to prior, the left lung base opacity is more conspicuous, particularly on the frontal exam, and it was new from <unk>. Elsewhere, the lungs are clear. There is a small right effusion with possible trace left effusion as well. Cardiac silhouette is enlarged but stable. Atherosclerotic calcification is again seen at the aortic arch.
<unk>-year-old male with shortness of breath.
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As compared to the previous radiograph, a pre-existing atelectasis at the level of the right upper lobe has completely resolved. The lung parenchyma appears well ventilated, there is no evidence of pneumonia or pulmonary edema. No pleural effusions. Borderline size of the cardiac silhouette. Right and left internal jugular vein catheters as well as the nasogastric tube are in unchanged position.
evaluation for pneumonia.
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Chain sutures are present in the right mid lung. There has been no significant change in the extent of the pre-existing pleural effusions. There is no new pneumonia, pulmonary edema or pneumothorax. Mediastinal silhouette including the median sternotomy wires and valve replacement are stable.
malignant effusion and aspiration status post thoracentesis, evaluate pleural effusions.
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Left-sided aicd/pacemaker device is noted with leads terminating in the right atrium and right ventricle. The patient is status post median sternotomy and cabg. Moderate cardiomegaly is re- demonstrated, and the mediastinal contours are unchanged. Worsening alveolar opacities are noted predominant within the right mid lung field and left lung base. Continued vascular indistinctness and perihilar haziness is again seen. These findings likely reflect worsening moderate pulmonary edema, though developing areas of infection in the right mid lung field and left lung base cannot be completely excluded. Small bilateral pleural effusions are noted. There is no pneumothorax. No acute osseous abnormalities demonstrated.
congestive heart failure, increasing shortness of breath.
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Ap chest radiograph. There is moderate pulmonary edema with pulmonary vascular engorgement and bilateral pleural effusions. The cardiac silhouette is obscured, but moderately enlarged. There is no pneumothorax. Moderate dextroscoliosis of the thoracic spine is noted.
history: <unk>m with fever, hypoxia at triage // eval for pna
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There has been placement of a dobbhoff tube that coils in the lower body of the stomach. Extremely limited study due to scattered radiation related to the size of the patient. Tracheostomy tube appears to be in good position and a right ij catheter extends to the mid to lower portion of the svc. Bilateral pulmonary opacifications are again seen, more prominent on the right.
dobbhoff placement.
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Frontal and lateral views of the chest were compared to previous exam from <unk>. There are left greater than right pleural effusions, similar in appearance when compared to prior. Superiorly, the lungs are clear. The cardiac silhouette is essentially unchanged. Dual-lead pacing device again seen. Osseous and soft tissue structures are grossly unremarkable. Atherosclerotic calcifications noted in the abdominal aorta as well as abdominal surgical clips.
<unk>-year-old female with cough.
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Pa and lateral views of the chest provided. Faint areas of scarring again noted in the periphery of the right mid lung. Otherwise the lungs are clear. No pleural effusion or pneumothorax. Cardiomediastinal silhouette is stable with an unfolded thoracic aorta. Scoliosis again noted.
<unk>f with crackles b/l lung fields
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Following transbronchial biopsy, there is no evidence of pneumothorax. No acute cardiopulmonary disease. Dual-channel pacer device remains in place.
transbronchial biopsy, to check for pneumothorax.
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Frontal and lateral chest radiographs again demonstrate a left chest wall pacer device with the leads overlying the right atrium and ventricle, unchanged in position. There is a normal cardiomediastinal silhouette and well-aerated lungs which are clear. No focal consolidation, pleural effusion, or pneumothorax is seen. The visualized upper abdomen is unremarkable.
hypoglycemia. evaluate for acute process.
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The heart is at the upper limits of normal size. The mediastinal and hilar contours appear unchanged. There is probably a hiatal hernia but not as well demonstrated on this examination. There is similar background coarsening of lung markings, but otherwise the lungs appear clear. The lungs are hyperinflated. There is no pleural effusion or pneumothorax. Surgical clips project over the right upper quadrant. There is moderate rightward convex curvature centered along the thoracolumbar junction. The bones appear demineralized. Mild-to-moderate vertebral body height loss with a biconcave configuration along an upper lumbar vertebral body appears unchanged. Bones are difficult to evaluate, however, owing to marked demineralization. There is a lucency in the left scapula that probably represents an artifact or nutrient foramen. However, dedicated radiographs could be considered if symptoms, if any, refer to this area.
status post fall.
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Single supine view of the chest provided. The et tube terminates <num> cm above the carina. Lung volumes are low. There is a probable large left pleural effusion and underlying atelectasis, potential and consolidation. No evidence of pneumothorax. Increased opacity at the right perihilar region and lung base, possibly due to low lung volumes.
history: <unk>m with ett eval ett
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Significant increase in moderate left pleural effusion since <unk> obscuring the left heart border concerning for empyema. Right upper lobe and lower lobe opacities are less radiodense and smaller compared to <unk>. Right picc ends in the mid svc. Unchanged mediastinal silhouette.
cavitary lung lesions, mrsa bloodstream infection and recurrent fevers. picc placement and evaluate for pneumonia.
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Pa and lateral images of the chest demonstrate well expanded lungs. There is a thin-walled area of increased emphysematous changes at the left lung base consistent with what was previously described. If this area is clinically concerning, could consider a high-resolution ct scan of the chest to look for possible interstitial changes. There is no evidence of acute cardiac or pulmonary process. Visualized osseous structures are unremarkable.
<unk>-year-old female with left-sided chest pain and prior history of smoking and pneumothorax.
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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 evidence of pneumomediastinum is seen. There is no evidence of free air beneath the diaphragms.
history: <unk>m with chest pain s/p vigorous vomiting. // ? free air from esophageal perforation
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The heart is borderline enlarged. The aorta is mildly tortuous and partly calcified. There are probably trace pleural effusions bilaterally. Fissures are mildly thickened. Diffuse hazy opacification of each lung with a widespread reticular abnormality and bilaterally hilar enlargement suggests pulmonary edema. Findings are slightly more extensive in the right lung than left but largely symmetric.
history: <unk>m with hx of endocarditis with hypoxia and crackles at bases bilaterally.
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Lung volumes remain low. The lungs are clear. No focal consolidation, edema, effusion, or pneumothorax. Blunting of the posterior cp angles is chronic either from pleural thickening/ scarring and/or chronic effusion. The heart is normal in size. The descending thoracic aorta remains tortuous. Left curvature of the thoracic spine is again noted. No acute osseous abnormality. Multilevel degenerative changes in the thoracic spine are mild.
history: <unk>m with chest pain // r/o acute process
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Frontal and lateral views of the chest were obtained. Low lung volumes results in bronchovascular crowding. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiac and mediastinal silhouettes are unchanged. Pulmonary vasculature is within normal limits. The left pacemaker leads are in stable position. Prosthetic aortic valve is again seen. Median sternotomy wires are intact.
increasing dyspnea.
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Right picc line is in the mid to low svc. Enteric tube terminates in the stomach. Moderate right and small left pleural effusions with bibasal opacities. No interstitial edema. Calcified mass projecting over the left hemithorax peripherally measuring <unk>.<num> x <num> cm is a calcified pleural plaque. There also calcified diaphragmatic and mediastinal calcified pleural plaques. A possible pneumothorax is seen lateral to this large calcified pleural plaque.
<unk> year old man with recent af ablation, p/w tachyarrhytmia, report of aspiration at osh. // ? aspiration, consolidation, also please eval osh picc placement
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Frontal and lateral views of the chest were obtained. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. The hilar contours are also stable. No displaced fracture is seen.
chest pain x.
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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 aortic knob remains calcified. The cardiac and mediastinal silhouettes are unremarkable. There is no overt pulmonary edema.
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As compared to the previous radiograph, there is no relevant change. Moderate cardiomegaly with bilateral areas of atelectasis, but no evidence of overt pulmonary edema. No pleural effusions. No pneumothorax. The monitoring and support devices, including the left pectoral icd, are unchanged.
fluid overload, evaluation for interval change.
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The heart continues to be enlarged, and low lung volumes accentuate the bronchovascular markings. There is mild pulmonary edema, increased from prior exam, and no pleural effusions or focal consolidations are seen. There is chronic deformity of the left clavicle.
<unk> -year-old male with weakness, confusion. evaluate for infiltrate.
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Comparison is made to the previous study from <unk> at <time> a.m. There is again seen a right-sided pigtail catheter. No pneumothoraces are seen on either side. There is unchanged endotracheal tube, feeding tube, and left ij central line. The heart size is stable. There is an unchanged left retrocardiac opacity and likely left-sided pleural effusion.
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As compared to the previous radiograph, there is unchanged evidence of a normal cardiac silhouette with moderate tortuosity of the thoracic aorta. Elevation of the right hemidiaphragm, now with plate-like atelectasis at the right lung bases. Otherwise, the lung parenchyma appears normal. There is no evidence of acute changes such as pulmonary edema, pneumonia or pleural effusion. Normal hilar and mediastinal structures.
diabetes mellitus type <num>, status post liver transplant, preoperative chest radiograph.
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Ap and lateral views of the chest. There is an approximate <num> cm nodule identified at the left lung base not clearly seen on the prior. The lungs are otherwise clear without consolidation, effusion or pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits. Note is made of a probable hiatal hernia. Degenerative changes are noted in the spine. There is also a wedge deformity in the upper lumbar spine, age indeterminate. Osseous and soft tissue structures are otherwise unremarkable.
<unk>-year-old female with back pain.
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Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen.
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Comparison is made to previous study from <unk>. There is a swan-ganz catheter which is unchanged. Mediastinal drains and chest tube are also unchanged. Lvad device is identified. There is an unchanged left retrocardiac opacity. There are no pneumothoraces. The right lung and left lung apex appear clear. Overall, there has been no appreciable change.
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The lung volumes are noted to be low. No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. The heart size is normal. Mediastinal contours are normal. No bony abnormality is detected.
altered mental status, tachypnea.
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The patient is status post median sternotomy, aortic valve surgery, and corevalve placement. The appearance of the corevalve is similar to the prior post-procedural radiograph. The heart size is normal. The mediastinal contours are remarkable for tortuosity of the thoracic aorta and a large hiatal hernia. Patchy and linear opacities are present at the lung bases, and note is made of small pleural effusions bilaterally.
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The lungs are clear without focal consolidation, effusion, or edema. Incidentally noted is an azygos fissure. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. No acute cardiopulmonary process.
<unk>f with cough and chest pain // evaluate for pneumonia
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Lung volumes are low, and there are small bilateral pleural effusions. Heart size is top normal. There is central pulmonary vascular congestion, without pneumothorax or focal consolidation.
<unk>m with aflutter and severe mr. <unk> for pulmonary edema.
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A tracheostomy tube appears properly positioned though partially obscured by the patient's o<num> mask. There is no pneumothorax, focal consolidation, or pleural effusion. Mild bibasilar atelectasis is exaggerated by low lung volumes.
copd, post revision of tracheostomy.
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Pa and lateral views of the chest. Left chest wall dual lead pacing device is again seen. There are small bilateral effusions similar to prior. Streaky left basilar opacity is seen, potentially atelectasis noting that the infection is not completely excluded. Cardiomediastinal silhouette is unchanged. Surgical clips again project over the left lung likely from prior resection. No acute osseous abnormality detected.
<unk>-year-old male status post lung resection with shortness of breath.
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The lungs are clear and the cardiac and mediastinal contours are accentuated by portable technique, but stable since <unk>. There is no pleural effusion or pneumothorax.
history: <unk>f with leukocytosis // pna?
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The lung volumes are low. There is possible enlargement of the right hilum. There is no focal opacity, pulmonary edema, pleural effusion or pneumothorax. The trachea is deviated to the left.the heart size is probably normal.
<unk>m with pupuritic rash, productive cough. evaluate for pneumonia.
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Again seen is a right picc line with tip terminating in the low svc. Median sternotomy wires are in position. Cardiomediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. The left retrocardiac opacity has improved since the prior study. No new focal parenchymal opacity is present.
evaluate pleural effusions.
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Ap single view of the chest has been obtained with patient in sitting semi-upright position. Comparison is made with the next preceding similar study obtained on <unk>, <time> hours. The previously described findings are unaltered, and the left apical pneumothorax measuring <num>-<num> cm in width in the apical area persists. The position of the left-sided chest tube is unaltered and so are the previously described densities.
<unk>-year-old female patient with chest tube interval change.
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Lungs are clear. Cardiac silhouette is normal. No pleural effusion or pneumothorax. No acute appearing bony abnormalities are appreciated, however there is minimal anterior wedging of a lower thoracic vertebral body, potentially chronic. Clinical correltion is suggested.
trauma.
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In comparison with the study of <unk>, the monitoring and support devices are essentially unchanged. The degree of pulmonary edema has substantially increased. Opacification at the left base persists, which could reflect superimposed pneumonia or hemorrhage. There are probable small bilateral pleural effusions with some underlying atelectatic changes.
cardiac arrest, to assess for collapse or pneumothorax.
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Allowing for differences in technique and projection, there has not been a substantial change in the appearance of the chest since the recent study of one day earlier.
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Right-sided port-a-cath tip terminates in the svc. The heart size is normal. Mediastinal and hilar contours are unchanged. There has been interval improvement in aeration of the left lung base. A small left pleural effusion is likely present. Persistent partially loculated small to moderate right pleural effusion is unchanged with adjacent right basilar opacity likely reflecting compressive atelectasis. No pulmonary edema or pneumothorax is identified.
febrile neutropenia.
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A left-sided port-a-cath is again seen, terminating at the cavoatrial junction. Small right pleural effusion is seen. There is stable enlargement mild of the cardiac silhouette. Again seen is engorgement of the central pulmonary vessels consistent with elevated pulmonary venous pressure. Subtle left base retrocardiac opacity may relate to pulmonary congestion although underlying consolidation is difficult to exclude. No pneumothorax is seen.
history: <unk>f with o<num> requirement left leg swelling s/p recent <num> week hospitalization // ?dvt, eval heart and lungs
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Mild pulmonary edema is new. Left loculated small pleural effusion/chylothorax is unchanged in this patient with severe cardiomegaly. There is no pneumothorax.
patient with heart failure; chylothorax and non-small cell lung cancer, worsening dyspnea. assess for worsening of pleural effusion.
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The lungs are clear without focal consolidation, effusion, or edema. Patient is rotated the left. Within this limitation the cardiomediastinal silhouette is stable. Tortuosity of the descending thoracic aorta is noted. Mid thoracic dextroscoliosis is unchanged. No acute osseous abnormalities.
<unk>f with shortness of breath // eval for pulmonary edema