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Tracheostomy, right subclavian Port-A-Cath and left internal jugular central line are unchanged in position. Overall cardiac and mediastinal contours are stable. There are layering bilateral effusions with retrocardiac consolidation most likely representing compressive atelectasis, although pneumonia cannot be excluded... | |
In comparison with the study of ___, there is continued enlargement of the cardiac silhouette with substantial pulmonary edema and bilateral pleural effusions, more prominent on the right. An impression on the lower cervical trachea to the right raises the possibility of a thyroid mass. | |
Worsening of bilateral pleural effusions, especially on the right, with bibasilar atelectasis. Mild vascular congestion unchanged. Enlarged cardiac silhouette, unchanged from previous. There is no pneumothorax. | |
Lung volumes are lower and mild to moderate bibasilar atelectasis is new following tracheal extubation and removal of the left basal pleural drainage catheter. There is no appreciable pneumothorax or left pleural effusion. Small right pleural effusion may be present. Heart size top-normal. Normal postoperative mediasti... | |
In comparison with the study of ___, there is worsening of the diffuse bilateral pulmonary opacifications. Given the enlargement of the cardiac silhouette, much of this could represent pulmonary edema. However, in the appropriate clinical setting, it would be impossible to exclude 1 or multiple areas of pneumonia. Poor... | |
Since the prior study there is interval increase in right pleural effusion as well as left pleural effusion although it may be potentially related to the more supine been before position of the patient. Tubes and lines are in unchanged position. Mild interstitial enlargement is noted slightly more progressed as compare... | |
AP portable upright view of the chest. Lung volumes are low limiting assessment. Subtle perihilar opacities likely represent bronchovascular crowding though difficult to exclude a component of mild congestion. No definite signs of pneumonia, effusion or pneumothorax. The heart size appears within normal limits. The med... | |
Evaluation is limited due to patient rotation. Additionally, the inspiratory lung volumes are decreased with resultant bronchovascular crowding and accentuation of the cardiomediastinal silhouette. There is opacification of the left lung base greater than the right superimposed on background diffuse interstitial abnorm... | |
Comparison is made to the previous study from ___. Swan-Ganz catheter has been readjusted, the distal tip is now at the main pulmonary artery outflow tract. Endotracheal tube tip is at the level of the clavicles. Nasogastric tube side port is at the GE junction and could be advanced several centimeters for more optimal... | |
Heart size is normal. Mediastinum is normal. NG tube tip is in the stomach. Lungs are essentially clear. There is no pleural effusion or pneumothorax. | |
A portable frontal chest radiograph demonstrates a left chest wall pacer device with leads overlying the right atrium and ventricle, and endotracheal tube terminating in the mid to upper thoracic trachea, approximately 6.5 cm from the carina, and an enteric tube terminating in the stomach. The cardiomediastinal silhoue... | |
In comparison with the study of ___, there is continued enlargement of the cardiac silhouette with evidence of elevated pulmonary venous pressure. Bibasilar opacifications, more prominent on the right, are consistent with a combination of pleural effusion and compressive atelectasis at the bases. In the appropriate cli... | |
Since prior, left pleural effusion has slightly decreased in size. The lungs are grossly clear. Cardiomediastinal silhouette is unchanged. Small right pleural has resolved. There is no pneumothorax. | |
An endotracheal tube and enteric tube are unchanged in position. The TandemHeart catheter now projects over the mid heart, which is more cephalad compared to the prior study and could be in the pulmonary outflow tract. There is improved aeration of the lung apices with redistribution of pleural fluid into the bases. A ... | |
In comparison with the study of ___, there is little change. Continued enlargement of the cardiac silhouette in this patient with intact midline sternal wires. There is mild indistinctness of pulmonary vessels, which could represent some elevation of pulmonary venous pressure. No evidence of acute focal pneumonia. | |
Right internal jugular Swan-Ganz catheter unchanged in position. Stable cardiac enlargement. There are bibasilar patchy opacities with associated pleural effusions favoring atelectasis. There is interval worsening of mild pulmonary edema. | |
Bands of opacity in the lower lungs looks more like atelectasis than pneumonia. Upper lungs are grossly clear. Heart size is normal. There is no pleural abnormality. | |
Patient is rotated to the left. Dobbhoff tube is seen, which has been advanced since the prior study, terminating in the stomach, however, does not appear post-pyloric. Bilateral pleural effusions and bibasilar atelectasis persist. Rounded opacity at the right lung base is again seen. | |
ET tube tip lies at the lower edge of the clavicular heads, approximately 6.3 cm above the carina. Right IJ Swan-Ganz catheter tip over proximal right pulmonary artery. Left IJ central line tip over distal SVC. NG tube tip over gastric fundus. Left paratracheal surgical clips again noted. Allowing for overlying lines a... | |
There has been interval advancement of the enteric feeding tube which now projects below the level of the diaphragms but beyond the field of view of this radiograph. The tip of the endotracheal tube projects over the mid thoracic trachea. A right internal jugular central venous catheter is unchanged. Unchanged left low... | |
As compared to the previous radiograph, the patient has received a right internal jugular vein catheter. The course of the catheter is unremarkable, the tip of the catheter is difficult to visualize, given that it projects over the pacemaker leads. The tip appears to be located in the mid to lower SVC. There is no evid... | |
Right pigtail catheter is in place. Interstitial markings appear to be even more pronounced than on the prior study. Subcutaneous air within the right chest wall has decreased in size. Cardiomediastinal silhouette is unchanged. | |
There has been interval placement of a right internal jugular central venous catheter which terminates in the low SVC/ cavoatrial junction without evidence of pneumothorax. Mild basilar atelectasis is seen without definite focal consolidation. No large pleural effusion or pneumothorax is seen. The cardiac and mediastin... | |
In comparison with the study of ___, the patient has taken a better inspiration. Tracheostomy tube remains in place. Cardiomediastinal silhouette is stable. Opacification at the right base again is worrisome for aspiration in the appropriate clinical setting. | |
Endotracheal tube tip terminates 7 cm from the carina. An enteric tube tip is noted within the stomach. The cardiac and mediastinal contours are unremarkable. Diffuse hazy alveolar opacities are noted bilaterally, more pronounced on the right, compatible with moderate pulmonary edema. There may be trace bilateral pleur... | |
The lungs are grossly clear. Cardiac silhouette appears enlarged but likely exaggerated by AP portable technique. Known diffuse sclerotic bony metastases are visualized. | |
Lung volumes are low. There is mild bibasilar atelectasis but no focal opacity to suggest pneumonia. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. | |
CHEST, SINGLE AP PORTABLE VIEW. Compared with the earlier film, I doubt significant interval change. Heart size is borderline or slightly enlarged. There is hazy opacity along the left lung, more pronounced peripherally, and subsegmental atelectasis at the right base, similar to the prior film. No gross effusion is ide... | |
Comparison to ___. Lung volumes are low. New areas of atelectasis at the right lung bases, minimal right pleural effusion. Mild overinflation of the stomach. Borderline size of the cardiac silhouette without overt pulmonary edema. | |
Patchy opacity at the right base would be concerning for pneumonia or aspiration, less likely atelectasis. Clinical correlation is advised. No evidence of pulmonary edema, large effusions or pneumothorax. Prominent dilated tortuous aorta raising the possibility of an aortic aneurysm. Heart is normal in size. Two faint ... | |
No relevant change as compared to ___. In the interval, the patient has been extubated and the nasogastric tube was removed. The size of the cardiac silhouette is slightly enlarged. There are signs of bilateral mild basal apical blood flow redistribution, suggesting mild pulmonary edema. In addition, subpleural, periph... | |
In comparison with the study of ___, there is little overall change in the appearance of the heart and lungs. Continued enlargement of the cardiac silhouette with elevation of pulmonary venous pressure. Very layering effusion on the left with basilar atelectasis. The Dobbhoff tube appears to have been replaced by a nas... | |
Right IJ catheter extends to the mid portion of the SVC. No evidence of pneumothorax. No evidence of acute cardiopulmonary disease. | |
Combination of severe atelectasis and small to moderate left pleural effusion unchanged for several days. There is no longer any pulmonary edema. Right pleural effusion is small. Severe enlargement of cardiac silhouette is stable over the past several days, but improved since ___. No pneumothorax. Feeding tube passes i... | |
In comparison with the study of ___, the monitoring an support devices are essentially unchanged. The pulmonary vascularity continues to improve and atelectatic changes are again seen at the bases. | |
A pigtail catheter is again seen overlying the right upper quadrant. Lung volumes are somewhat diminished and there is increasing opacity in the retrocardiac region with a suggestion of air bronchograms which either reflects partial lower lobe atelectasis or could be consistent with a developing pneumonia. Clinical cor... | |
The lungs remain clear. The cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications are noted at the aortic arch. No acute osseous abnormalities identified. | |
Cardiac silhouette size is normal. Mediastinal and hilar contours are unremarkable. No pulmonary edema is identified. Streaky opacities in the lung bases likely reflect areas of atelectasis. No pleural effusion or pneumothorax is demonstrated. There are no acute osseous abnormalities. | |
AP portable upright view of the chest. An NG tube courses inferiorly along the thoracic midline into the left upper abdomen though the tip is excluded from view. The endotracheal tube is seen with its tip located 4.3 cm above the carina. The lungs are grossly clear. Cardiomediastinal silhouette appears grossly unremark... | |
Support lines and tubes are unchanged in position. There is cardiomegaly which is stable. There are low lung volumes. There is a left retrocardiac opacity. There is likely a left pleural effusion. No pneumothoraces are seen. | |
Compared to prior chest radiographs ___ through ___. Emphysema is severe. Interstitial edema, left lung slightly more pronounced. Heterogeneous opacification in the right lung has been variable of the past several days, but not improved, probably a combination of pneumonia, atelectasis and edema, and small right pleura... | |
In comparison with the earlier study of this date, there has been placement of a left mainstem bronchus shunt with substantial Re aeration of the left hemithorax. Persistent opacification at the left base most likely represents atelectasis. In the appropriate clinical setting, superimposed pneumonia would be difficult ... | |
A nasogastric catheter has been repositioned and now courses below the diaphragm with tip in the region of the stomach. A pacemaker generator and leads are in unchanged expected position. Lung volumes remain low. No other significant interval from multiple recent prior examinations is evident. | |
In comparison with the study of ___, there is continued enlargement of the cardiac silhouette with probable small effusions and volume loss most prominently in the left lower lung. Mild elevation of pulmonary venous pressure persists. | |
Portable AP radiograph of the chest was reviewed in comparison to ___. Since the prior study, there is no change in the relatively deep position of the tip of the right internal jugular line being in the proximal right atrium. The patient continues to be in pulmonary edema associated with large amount of pleural effusi... | |
An endotracheal tube has been removed and replaced with a new tracheostomy. The upper mediastinal and tracheal contours are not optimally, but the tracheostomy appears within normal limits. A left-sided PICC line and right internal jugular venous catheter appear unchanged. There is still a chest tube in the left lower ... | |
Comparison to ___. No relevant change. Borderline size of the cardiac silhouette. Mild elongation of the descending aorta. No pulmonary edema. No pleural effusions. No pneumonia. Hypotrophic first right rib. | |
The lungs are normally expanded and clear. There is no focal airspace opacity or pulmonary edema. Heart size is top normal. The mediastinal and hilar contours are normal. There is no large pleural effusion. There is no pneumothorax. | |
Slight increase in extent of the pre-existing small left pleural effusion. Increase in extent of the retrocardiac atelectasis and the associated parenchymal opacity. Mild cardiomegaly persists. The right lung continues to be normal. | |
There is no significant interval change. Support lines and tubes are unchanged in position. Cardiac silhouette is enlarged and stable. There remains pulmonary edema and a left retrocardiac opacity. There are no pneumothoraces. | |
Nasogastric tube tip projects over the medial aspect of the right hemidiaphragm and appears to terminate within a large hiatal hernia which is distended with air and fluid. The cardiac silhouette size is moderately enlarged. The aortic knob is calcified. Bibasilar ill-defined opacities may reflect aspiration or atelect... | |
Cardiomediastinal contours are normal and midline. Extensive bilateral large consolidations worse in the left are unchanged. There is no pneumothorax or enlarging effusions. Lines and tubes are in unchanged standard position. Catheter projects in the upper abdomen. | |
In comparison with the earlier study of this day, there is little overall change. . Monitoring and support devices remain in good position. Bibasilar opacifications are again seen in the upper lung zones are clear without evidence of pulmonary vascular congestion. | |
AP chest compared to ___ and chest CT, ___: Previous mild interstitial abnormality has cleared, probably edema. Moderate consolidation at the lung bases has improved. There is no pleural effusion. Heart size normal. ET tube in standard placement. Nasogastric tube looped in the stomach. | |
New compared to prior are bibasilar opacities, more extensive on the right than on the left. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. | |
As compared to the previous radiograph, there is increased diameter of the pulmonary vessels, and mild peribronchial cuffing, suggesting mild pulmonary edema. In addition, a moderate pleural effusion has newly appeared on the left. Minimal atelectasis at the right lung base. Unchanged moderate cardiomegaly. No pneumoth... | |
AP view of the chest provided. Bibasilar opacities likely reflect atelectasis. Cardiomediastinal and hilar contours are normal. There is a tiny pleural effusion on the right. There is no pneumothorax. | |
Mild pulmonary vascular congestion is stable. There is no pneumothorax or pleural effusion. Mediastinal contour and mild cardiomegaly are stable. | |
All the monitoring devices are unchanged in standard position, in particular, right subclavian PICC ends in mid SVC, and NG tube ends in mid gastric cavity. The patient is after cardiac surgery, sternal wires are projected in midline. Lung volume is low with bilateral opacification for moderate pulmonary edema. New opa... | |
Previous moderately severe pulmonary edema has improved. Small right pleural effusion remains. Heart borderline enlarged unchanged. No pneumothorax. | |
As compared to the previous radiograph, no relevant change is seen. The monitoring and support devices are in constant normal position. Unchanged size of the cardiac silhouette. Unchanged presence of mild fluid overload, bilateral mild to moderate pleural effusions as well as relatively extensive basal and retrocardiac... | |
As compared to the previous radiograph, there is no substantial change in position of the endotracheal tube. The tip projects approximately 6 cm above the carina. The tube could be advanced by 1 to 2 cm. The right internal jugular vein catheter is constant. Constant appearance of the lungs and the heart. No evidence of... | |
An endotracheal tube terminates 6.6 cm above the carina. An orogastric tube extends to the stomach. Known bilateral pulmonary nodules are unchanged, measuring up to 2 cm, better seen on the prior reference CT examination from ___. However, there is a new left retrocardiac opacity since ___, reflecting atelectasis versu... | |
Moderate multiloculated left pleural effusion is smaller now than on ___, but is still extensive, and in combination with restrictive pleural thickening is probably responsible for sub considerable left lower lobe atelectasis. Small right pleural effusion persists despite the right-sided pleural drainage catheter. Ther... | |
Compared with 1 day prior, I doubt significant interval change. Again seen an aortic replacement device in relation to the ascending aorta. Cardiomediastinal silhouette appears similar. Possibility of slight volume loss on the left cannot be excluded, similar to prior. There are bilateral effusions with underlying coll... | |
ET tube tip is 6.6 cm above the carinal. NG tube tip is in the stomach. Right central venous line tip is at the level of lower SVC. Heart size and mediastinum are stable. Bibasal consolidations are demonstrated. A left chest tube is in place. There is substantial interval decrease in pneumothorax, currently minimal wit... | |
Lung volumes have improved. Mild to moderate interstitial pulmonary abnormality has changed in distribution, and improved slightly over night. Since chronic cardiomegaly is accompanied by mediastinal venous engorgement, I suggest the abnormality is largely edema. There is now the suggestion of lung nodules that could h... | |
The heart size is upper limits normal. Is not NG tube with tip in the stomach. The ET tube tip is 6.5 cm above the carina. There is dense consolidation volume loss in the right lower lobe with an effusion tracking into the major fissure there is also increased opacity at the right hilum questionable etiology. Attention... | |
Interval removal of a tracheal, right mainstem, and left mainstem a bronchus stent. The lung volumes are low bilaterally leading to crowding of the bronchovascular structures. There is no focal consolidation, pleural effusion, or pneumothorax identified. The cardiac silhouette is top normal in size. | |
Heart size and mediastinum are stable. Lungs are essentially clear. No pleural effusion or pneumothorax is seen. | |
Comparison to ___, 22:25 as compared to the previous radiograph, there is increasing consolidation in the retrocardiac lung region. Otherwise, the radiograph is unchanged. Mild overinflation. Pre-existing parenchymal opacities at both lung bases, right more than left. No pneumothorax. Normal size of the heart. No large... | |
As compared to the previous radiograph, the patient has received right pectoral Port-A-Cath. The tip of the line projects over the mid to lower SVC. There also is a minimal retrocardiac atelectasis. No pneumonia, no pulmonary edema. No pneumothorax. | |
Significant left pleural effusion has minimally decreased in size with a new Pleurx catheter projecting at the lung base. There is no pneumothorax. The remaining of the lungs and mediastinum are unremarkable. | |
There are no old films available for comparison. The heart is severely enlarged. There is complete obscuration of the left heart border and left hemidiaphragm, it is unclear how much of this is due to overlying soft tissue or if an infiltrate or effusion is present. There is blunting of the right CP angle. Again, it is... | |
Heart is top-normal size. Pulmonary vasculature is borderline engorged but there is no pulmonary edema or appreciable pleural effusion. Widening of the upper mediastinum could be due to fat deposition or enlarged thyroid. Clinical correlation advised. | |
As compared to the previous radiograph, there is a newly appeared focal parenchymal opacity at the bases of the left lung. Opacity was not visible on the previous image. The opacity also partially blunts the left heart contour. In the appropriate clinical setting, this finding is likely to reflect pneumonia. At the tim... | |
Left mid line tip terminates at the proximal aspect of the left subclavian vein. Cardiomediastinal silhouette is unchanged but there is interval progression of right lower lobe opacity concerning for aspiration versus pneumonia. Left basal atelectasis overall is unchanged as well as left suprahilar opacity better appre... | |
Heart size and mediastinum are stable. Lungs are clear. There is no pleural effusion or pneumothorax. | |
Lung volumes are unchanged compared to the prior study. Support and monitoring equipment also unchanged. There are persistent diffuse bilateral airspace opacities. These are more confluent in the lower lobes but also affect the apices. A vascular stent is seen in the left axilla and left subclavian area. No pleural eff... | |
Mild pulmonary edema continues to be seen, but interval improvement is noted. Heart size has decreased in size but continues to be mildly enlarged. No consolidation, pneumothorax or pleural effusion is seen. | |
Right distal clavicular fracture is a partially imaged on this radiograph. Since the prior study, the endotracheal tube has been advanced, no terminating less than 3 cm from the carina. Left-sided PICC line terminates in the upper right atrium. Enteric tube terminates in the left upper quadrant, as before. Heart size i... | |
Bilateral heterogeneous opacification, left greater than right, improved particularly on the right compared to ___. Findings are consistent with resolving severe aspiration pneumonia or pulmonary hemorrhage or reaction to inhaled substances. There is no indication that this is cardiogenic edema. Heart is normal size, p... | |
AP radiograph of the chest was compared to ___ obtained at ___. The ET tube tip is 4.2 cm above the carina. The Swan-Ganz catheter tip is at the level of the right lobar pulmonary artery. Heart size and mediastinum are unchanged. There is slight interval improvement in widespread parenchymal opacities. No pneumothorax ... | |
In comparison with the study of ___, the right IJ catheter has been removed. Patient has taken a better inspiration and the hemidiaphragms are now sharply seen. Mild atelectatic streak is seen in the left mid to lower zone. No evidence of vascular congestion. Cardiac silhouette remains mildly enlarged. | |
Portable AP radiograph of the chest was reviewed in comparison to ___. The NG tube tip passes below the diaphragm terminating in the stomach. The right internal jugular line tip is at the mid SVC. Heart size and mediastinum are stable, but there is interval progression of bibasilar opacities that might reflect atelecta... | |
IABP terminates 1.7 cm below superior aspect of the aortic arch. Shallower inspiration. Otherwise no significant change. | |
The lungs are clear without focal consolidation or edema. There is no large effusion visualized. The cardiomediastinal silhouette is within normal limits. Changes partially visualized at the left shoulder may be degenerative or posttraumatic. | |
Severe infiltrative pulmonary abnormality worsened from ___ through ___ and has not changed appreciably. Heart size top-normal. Pleural effusions are presumed, but not large. No pneumothorax pre | |
The endotracheal tube and NG tube and left IJ line have been removed. The heart continues to be moderately enlarged and there continues to be dense left lower lobe consolidation. Due to the opacity in the left lower lobe, it is difficult to tell if an effusion is also present. There is mild pulmonary vascular redistrib... | |
There are increasing consolidations in the right upper lobe and at both lung bases consistent with known multifocal pneumonia. No pulmonary edema. No pneumothorax. Overall cardiac and mediastinal contours are stable. Likely small layering effusions. | |
AP chest compared to ___: Severe multifocal pulmonary consolidation, hemorrhage, and/or pneumonia have not improved. Mild interstitial edema has developed in the uninvolved portions of the lungs. Heart size is top normal. No pneumothorax. Pleural effusions are small, if any. Right jugular line, ET tube, and newly place... | |
As compared to the previous radiograph, there is no relevant change. The monitoring and support devices are in constant position. Normal size of the cardiac silhouette. No focal parenchymal opacity suggesting pneumonia. | |
Single AP upright portable view of the chest was obtained. There is mild left base atelectasis. No focal consolidation, pleural effusion, evidence of a pneumothorax is seen. The cardiac silhouette is mildly enlarged, likely in part exaggerated by AP technique. The aorta is tortuous. Hilar contours are stable. Multiple ... | |
The heart is borderline enlarged. Lungs are low in volume and clear aside from mild pulmonary vascular congestion. There is no edema or evidence of pneumonia and no pleural abnormality. | |
Bilateral lower lobe consolidation has changed in appearance but has not improved over the past several days. Pleural effusions are small if any. Heart size top-normal unchanged. No pulmonary edema. No pneumothorax. Tracheostomy tube midline. Right subclavian line ends in the low SVC. Esophageal drainage tube passes in... | |
AP single view of the chest was obtained with patient in semi-upright position. The heart is not enlarged. Thoracic aorta mildly widened and elongated but without local contour abnormalities. The pulmonary vasculature is not congested. No signs of acute or chronic parenchymal infiltrates are seen and the lateral pleura... | |
AP radiograph of the chest was reviewed in comparison to prior study obtained on ___ and ___. The right basal consolidation continues to slightly increase, with minimal interval change when compared to ___, with slightly more pronounced change when compared to ___. Minimal amount of apical pneumothorax is noted. Pleura... | |
There is unchanged evidence of mild overinflation. No pneumonia, no pulmonary edema, no pleural effusions. Normal size of the cardiac silhouette. Mild elongation of the descending aorta. Skin fold over the right lower hemi thorax is not a pneumothorax. | |
Comparison to ___. The patient continues to be intubated. The patient also carries a feeding tube. The right internal jugular vein device has been pulled back, the tip is now at the low SVC. No complications, no pneumothorax. The inferior vena cava device is in stable position. | |
As compared to the previous radiograph, the monitoring and support devices are in overall stable position. The endotracheal tube projects approximately 3.5 cm above the carinal with its tip this is approximately 1.5 cm higher than on the previous image. Left retrocardiac atelectasis, potentially combined with a small p... |
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