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The heart size is normal. The hilar and mediastinal contours are normal. There is a left-sided port-a-cath which terminates in the right atrium. There is a subtle retrocardiac opacity which is likely secondary to atelectasis. There is no pleural effusion or pneumothorax. The visualized osseous structures are unremarkable.
history of lymphoma with cough and low-grade fever. please evaluate for pneumonia or infection.
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The lungs are clear. The cardiomediastinal silhouette and hila are normal. There is no pleural effusion and no pneumothorax.
<unk>-year-old with cough, please evaluate for pneumonia.
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The lungs are well expanded, without focal opacities. There might be mild bilateral hilar vascular engorgement but no focal opacities. Cardiomediastinal contour is unremarkable. There is no pleural effusion or pneumothorax. No subdiaphragmatic free air is identified.
<unk>-year-old male with epigastric pain. evaluate for pneumonia.
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Interval intubation with tip of endotracheal tube terminating about <num> cm above the carina. This could be withdrawn a few centimeters for standard positioning as discussed with dr. <unk> by telephone on <unk>. Nasogastric tube terminates within the stomach, and left picc has been advanced into the mid superior vena cava. Cardiomediastinal contours are normal. Patchy and linear bibasilar atelectasis are present, improving on the right and worse on the left.
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Frontal and lateral views of the chest demonstrate increased ap diameter of the chest and flattened hemidiaphragms, suggestive of underlying chronic lung disease. Linear opacities in the lung bases are stable and likely represent areas of scarring. There is no pleural effusion, focal consolidation or pneumothorax. Hilar and mediastinal silhouettes are unchanged. Heart size is top normal. No pulmonary edema.
syncope.
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Frontal and lateral views of the chest were obtained. Previously seen widespread parenchymal opacities have essentially resolved in the interval. There is slight blunting of the posterior left costophrenic angle suggesting a trace pleural effusion versus pleural thickening. Left base atelectasis is seen. The patient is status post median sternotomy and cabg. The cardiac silhouette is top normal. No overt pulmonary edema is seen.
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There is a left picc line which terminates in the mid svc. Bibasilar atelectasis, but no focal consolidations. The right pleural effusion appears to have decreased in size. The left pleural effusion has increased with loculations, now moderate in size. The pulmonary vasculature is normal. The cardiomediastinal silhouette is stable. There is no pneumothorax.
<unk> year old man s/p ex lap for pancreatic necrosis debridement, now w/ inc wbc. // assess for consolidation, atelectasis, or other etiology of inc wbc.
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Moderate to large layering bilateral pleural effusions have grown when compared with the prior study of <unk>. There is no focal consolidation, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. The right-sided picc line ends in the mid svc.
<unk> year old woman with cirrhosis, schf and with sob and volume up on exam. // ? pulmonary edema
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Mild cardiomegaly is is a stable. Right pleural effusion has markedly decreased now small. There is a right basal chest tube. Right pneumothorax is moderate. Right middle lobe atelectasis has worsened. Left central catheter tip is in the lower svc
<unk> year old man with medical thoracoscopy // pleurodesis s/p
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The heart size is normal. The mediastinal and hilar contours are unremarkable. The lungs are well expanded and clear. There is no evidence of pleural effusion or pneumothorax. The visualized osseous structures are unremarkable.
<unk>-year-old female with shortness of breath and cough who presents for evaluation.
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Lungs are mildly hypoinflated with crowding of vasculature and right lower lobe plate like atelectasis. No pleural effusion or pneumothorax. Stable cardiomediastinal silhouette with top-normal heart. Air-filled loops of bowel are noted.
<unk>f with t spine compression. preop evaluation.
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Cardiomegaly. The mediastinal and hilar contours are normal. There is calcification of the aorta, indicating atherosclerosis. There is prominence of the main pulmonary artery. The pulmonary vasculature is otherwise normal. There is bibasilar atelectasis. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities. There is mild elevation of the right hemidiaphragm.
<unk>-year-old woman with chest and upper abd pain. evaluate for free air, acute process
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Pa and lateral views of the chest provided. Lungs are hyperinflated and lucent compatible with known emphysema. No focal consolidation, large effusion or pneumothorax. No signs of edema or central vascular congestion. Bony structures appear intact though somewhat demineralized.
<unk>f with sob // edema? infiltrate?
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Ng tube has been removed. The remainder of the appearance of the lungs is unchanged.
disorientation and shortness of breath.
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Frontal and lateral views of the chest were obtained. The left costophrenic angle is not included on the frontal view. Patient is status post median sternotomy and cardiac valve replacement. The cardiac and mediastinal silhouettes are stable. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Evidence of dish is seen along the spine.
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<num> views of the chest demonstrate clear lungs. The cardiac, hilar and mediastinal contours are normal. No pleural abnormality is seen.
left-sided chest pain.
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Pa and lateral views of the chest. No prior. The lungs are clear of consolidation. There is no effusion or pneumothorax. The cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable.
<unk>-year-old male with acute onset of pleuritic chest pain and pain with inspiration.
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Normal heart size, mediastinal and hilar contours. No focal consolidation, pleural effusion or pneumothorax. No displaced rib fracture is identified.
<unk> yo m with assault last week // fracture?
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Tracheostomy tube is in stable position. Left picc line again is seen with tip in the left brachiocephalic vein. The cardiomediastinal and hilar contours are stable. There is no pleural effusion or pneumothorax. New elevation of the left hemidiaphragm indicates volume loss. Overall there has been little change in the bibasilar opacities.
ventilator associated pneumonia, now with copious secretions.
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Single portable frontal chest radiograph demonstrates severe background emphysematous changes with relative lucency of the lungs and increased reticular nodular opacifications in the lung bases, left greater than right, the latter possibly representing developing infectious process or simply atelectasis. Focal nodular opacification projecting over the right lower lung. Unclear if this is within the lung parenchyma or external to patient. Not present on prior chest cts; recommend reevaluation with oblique radiographs or non-emergent chest ct. Cardiomediastinal and hilar contours are unremarkable. No pleural effusion or pneumothorax is evident.
shortness of breath, oxygen saturations <unk>% on room air. evaluate for pneumonia, chf, pneumothorax.
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The pulmonary vascular congestion is minimally worse since <unk>. No discrete lung opacities concerning for pneumonia. Moderately enlarged heart size is bigger than it was on <unk>. Mediastinal and hilar contours are normal. There is no pleural effusion.
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In comparison with the study of <unk>, the endotracheal tube has been removed and the swan-ganz catheter has been pulled back and replaced with a sheath in the ij. A chest tube remains in place, and there is no pneumothorax. The opaque portion of the dobbhoff tube straddles the esophagogastric junction. Apparent displacement of the mediastinum to the right most likely reflects obliquity of the patient. Nevertheless, there could be some volume loss in the right lower lung contributing to this appearance.
dobbhoff placement.
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Two frontal images of the chest demonstrate moderate pulmonary edema, which has worsened since prior imaging. There is increased opacity in the right lung base, consistent with a moderate right pleural effusion. There is a small left basilar opacity again seen, consistent with a small left pleural effusion and atelectasis. Moderate cardiomegaly is again seen, stable.
<unk>-year-old female with pulmonary edema.
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Cardiomegaly is accompanied by pulmonary vascular congestion and worsening pulmonary edema. More confluent opacities at the lung bases could reflect dependent edema and atelectasis, but a co-existing aspiration or pneumonia is possible in the appropriate clinical setting. Moderate right and small left pleural effusions are also demonstrated.
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The lungs are clear. There is no effusion, consolidation, or edema. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.
<unk>f with diffuse rash <num>d after r hand surgery, r scalene block; now w/ mild dyspnea // eval ? infection, r pneumothorax
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Pa and lateral chest views have been obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding similar study dated <unk>. Chest findings are now within normal limits. The previously identified fluid tracking in the major fissures has disappeared and the previously identified right-sided picc line has been removed.
<unk>-year-old female patient with acute lymphatic leukemia, pre-bone marrow transplant chest examination.
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As compared to the previous radiograph, no relevant change is noted. Metallic foreign body projecting over the left thyroid lobe. Normal lung volumes. Normal size of the cardiac silhouette. No pleural effusions. No pulmonary edema. No other abnormalities.
<unk>.
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Ap upright and lateral views of the chest provided. The lungs are clear. No signs of pneumonia or chf. No pleural effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm.
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Single ap upright portable view of the chest was obtained. There are low lung volumes, which accentuate the bronchovascular markings, particularly at the lung bases. Subtle bibasilar opacities are seen, which could relate to prominent bronchovascular markings and low lung volumes. However, in the appropriate clinical setting, early consolidation due to infection and/or aspiration is not excluded. There is no large pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable.
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In comparison with the study of <unk>, the monitoring and support devices remain in place. The tip of the endotracheal tube now measures approximately <num> cm above the carina. Cardiac silhouette is within upper limits of normal in size. There is stable elevation of pulmonary venous pressure. Hazy opacification at the right base is consistent with pleural fluid and mild basilar atelectasis.
acute liver injury with prolonged seizure.
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Heart size is normal. The aorta is mildly tortuous. Minimal atherosclerotic calcifications are noted at the aortic knob. Pulmonary vasculature is normal. Minimal streaky atelectasis is seen in the retrocardiac region. No focal consolidation, pleural effusion or pneumothorax is seen. Multilevel mild degenerative changes are noted in the thoracic spine.
history: <unk>m with chest pain
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The heart size is top normal. The aorta is mildly tortuous with atherosclerotic calcifications noted at the knob. There is an enteric tube which courses below the diaphragm with the tip within the stomach; however, with the side port immediately below the gastroesophageal junction. Bibasilar opacities, more pronounced within the left lung base are noted. There is no pneumothorax or large pleural effusion. Mild pulmonary vascular congestion is present. The visualized osseous structures are unremarkable.
history of desaturation and hypotension. please evaluate for pneumonia.
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As compared to the previous radiograph, the chest tubes are in unchanged position. There could be millimetric apical pneumothoraces, particularly on the right. However, the extent of these pneumothoraces is minimal. The swan-ganz catheter has been removed. The mediastinal drains remain in situ. Unchanged appearance of the heart and of the lung parenchyma.
evaluation for pneumothorax, chest tubes on waterseal.
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Comparison to the most recent preceding radiograph, there is a slight reaccumulation of fluid in the right pleural space. Two chest tubes are noted in that space. A tiny apical pneumothorax is present. Right atelectasis is also present. The left lung is essentially clear. Cardiac size is normal.
<unk>-year-old man status post pleurodesis for right lung effusion. please evaluate for residual effusion.
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Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. The lungs are clear. No pleural effusion or pneumothorax is seen.
<unk>m with fevers // ? pna
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Lung volumes are low. The heart size is mildly enlarged with a left ventricular predominance. The aorta is tortuous and demonstrates atherosclerotic calcifications. Mediastinal and hilar contours are otherwise unremarkable. Lungs are clear without focal consolidation. The pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. Mild degenerative changes are noted within the imaged thoracolumbar spine.
history: <unk>m with weakness and altered mental status//
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Pa and lateral views of the chest provided. Subsegmental lower lobe atelectasis noted bilaterally without convincing evidence of pneumonia or edema. No large effusion or pneumothorax. The heart appears mildly enlarged. Mediastinal contour is normal. No bony abnormalities are seen. No free air below the right hemidiaphragm.
<unk>m with hypoxia // ? pna
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The lungs remain clear. Again noted is a retrocardiac hiatal hernia, similar to prior. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable.
<unk>-year-old female with altered mental status. question pneumonia.
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Single supine view of the chest. Endotracheal tube is seen with tip <num> cm from the carina. Feeding tube passes off the inferior field of view. Vague linear right basilar opacity is most suggestive of atelectasis. Elsewhere the lungs are grossly clear and the cardiomediastinal silhouette is within normal limits. Likely chronic deformity of the lateral right clavicle. Potentially acute deformity of the proximal left humerus is incompletely visualized.
<unk>-year-old male with shortness of breath, intubated.
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A right internal jugular line is present with tip terminating near the cavoatrial junction. The et tube and enteric tube are in stable position. Moderate cardiomegaly persists. The mediastinal and hilar contours are stable. Bilateral pleural effusions are slightly decreased compared to the prior study. Pulmonary edema is also improved, now mild. Bibasilar consolidations persist and may reflect atelectasis or pneumonia.
<unk> year old woman with seizures, pneumonia // interval change
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The lung volumes are normal. Normal size of the cardiac silhouette. Mild tortuosity of the thoracic aorta. No pneumonia, no pleural effusion, no pneumothorax. No pulmonary edema.
cholecystitis, rule out pneumonia, evaluation.
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The lungs are symmetrically well expanded and well aerated without focal consolidation concerning for pneumonia. No pleural effusion or pneumothorax is detected. The pulmonary vasculature is within normal limits. The cardiac silhouette is top normal in size but unchanged. The mediastinal and hilar contours are within normal limits. The trachea is midline. The visualized upper abdomen demonstrates a tips shunt, as before.
history of cirrhosis, now with acute onset right shoulder pain and fever, here to evaluate for acute cardiopulmonary process.
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Heart size appears at least moderately enlarged, but assessment is limited due to the presence of small bilateral pleural effusions, left greater than right. Mediastinal and hilar contours are unremarkable. Mild pulmonary vascular congestion is noted with cephalization of pulmonary vascular markings. Bibasilar opacities likely reflect areas of atelectasis. No pneumothorax is identified. Mild to moderate compression deformity anteriorly of an upper lumbar vertebral body is new compared to <unk> but indeterminate in age.
history: <unk>f with dyspnea on exertion, history of congestive heart failure
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The lungs are clear without focal consolidation, effusion, or pulmonary edema. Enlarged cardiac silhouette is as on prior likely due to combination of cardiomegaly and pericardial effusion. No acute osseous abnormalities identified, although sclerosis of the vertebral bodies is again noted suggesting secondary hyperparathyroidism.
<unk>f w/ lupus nephrits, pulm htn p/w <unk>m/o hx of blood tinged sputum // r/o intrapulm process
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As compared to the previous radiograph, the lung volumes have decreased. As a consequence, there is crowding of the vascular and bronchial structures at both lung bases. In addition, mild areas of atelectasis have newly appeared, the atelectasis are more severe on the left than on the right. Borderline size of the cardiac silhouette without pulmonary edema. Blunting of the left costophrenic sinus, potentially caused by a minimal pleural effusion. At the time of dictation and observation, <time> a.m., the referring physician, <unk>. <unk> was paged for notification, <unk>.
shortness of breath, questionable pulmonary edema.
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As compared to the previous radiograph, there is no relevant change. The patient has received a tracheostomy tube. The tube appears to be in correct position. There is no evidence of pneumothorax. The appearance of the cardiac silhouette and the lung parenchyma are otherwise constant.
status post tracheoplasty, evaluation.
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Right pleural effusion has decreased in size with residual small pleural effusion remaining. Associated slight improvement in atelectasis at the right base. Left lower lobe atelectasis and adjacent small left pleural effusion are unchanged.
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Patient is status post median sternotomy and cabg. Left-sided dual-chamber pacemaker device is noted with leads terminating in unchanged positions. Heart size remains mildly enlarged. Mediastinal and hilar contours are normal. Pulmonary vasculature is normal. Minimal streaky opacities at the lung bases likely reflect areas of atelectasis and or scarring. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities.
history: <unk>m with shortness of breath, fever
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As compared with prior examination dated dated <unk>, there has been minimal interval change. Redemonstrated is a left-sided aicd with a single lead noted to be terminating within the right ventricle. There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema identified. Stable, moderate cardiomegaly is again noted. Mediastinal and hilar contours are normal.
history of heart failure, now with acute on chronic cough.
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Heart size is normal. Aortic knob is calcified. Mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is present. Moderate anterior compression deformity of a mid thoracic vertebral body is of indeterminate age.
history: <unk>f with hyperglycemia, dizziness, fatigue
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Bilateral lung volumes are low. Lungs are now better aerated as compared to the prior radiograph from <unk>. Pulmonary edema has resolved. Bilateral increased lower lung opacities likely from lobar collapse and probable right middle lobe collapse is persisting. Associated bilateral mild-to-moderate pleural effusions are similar. Mild- to moderate-sized hiatal hernia is present. Aorta is remarkable for moderate atherosclerotic calcification and mild tortuosity. Heart size is normal.
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In comparison with the study of <unk>, the left chest tube has been removed and there is no evidence of acute pneumothorax. Hazy opacification bilaterally with preservation of pulmonary vessels, more prominent on the right, is consistent with layering pleural effusions. The other monitoring and support devices are essentially unchanged.
chest tube removal, to assess for pneumothorax.
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The cardiac, mediastinal and hilar contours appear unchanged. There is increased opacification of the left mid to lower lung suggesting pneumonia with the greatest suspected degree of involvement in the superior segment of the left lower lobe. There is a similar mild interstitial abnormality involving both lungs which alternatively suggests mild pulmonary edema. There is no definite pleural effusion or pneumothorax. Sclerotic bones suggest renal osteodystrophy.
fever. question pneumonia.
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Comparison is made to prior study from <unk>. The cordis has been removed. There has been placement of a dobbhoff tube whose distal tip is at the ge junction. This could be advanced <unk>-<num> cm for more optimal placement. The tracheostomy tube whose distal tip is <num> cm above the carina, appropriately sited. There is again seen a left retrocardiac opacity. There is unchanged cardiomegaly. There is some atelectasis at the lung bases. There are no pneumothoraces. There is a left-sided central venous line with the distal lead tip in the distal svc.
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As compared to the previous radiograph, there is no relevant change. Low lung volumes. Tracheostomy tube and right-sided picc line in situ. Platelike atelectasis at the right lung bases. No overt pulmonary edema. No pleural effusions.
status post tracheostomy, decreased saturation, evaluation for interval change.
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As compared to the previous radiograph, there is a decrease in extent and severity of the generalized pulmonary nodules. However, the nodules are still clearly visible. No pleural effusions, no lymphadenopathy. Normal size of the cardiac silhouette.
history of miliary tb, evaluation.
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In comparison with the study of <unk>, the right ij catheter has been removed. Other monitoring and support devices are essentially unchanged. Increased opacification at the right base again most likely reflects pleural effusion with underlying atelectasis. However, in the appropriate clinical setting, superimposed infection cannot be excluded.
shortness of breath.
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The lungs are hyperinflated with flattening of the diaphragms, suggestive of copd. Again seen is chronic atelectasis/scarring notable at the right base. No new focal parenchymal opacity to suggest pneumonia is seen. No pleural effusion, pulmonary edema or pneumothorax is present. The heart size is within normal limits. There is mild tortuosity of the aorta with dense atherosclerotic calcification.
weeks of shortness of breath.
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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> year old man with pmh of ms with <unk>/o latent tb here requiring confirmation no evidence of active tb for housing // eval for e/o tb
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An opacity along the minor fissure seen only on the lateral view could be developing pneumonia in the right middle lobe or lingula in correct clinical setting. It is unclear if this is an artifact from rib shadowing. There is no pleural effusion or pneumothorax. Cardiomediastinal and hilar silhouettes are normal size.
<unk> year old woman with febrile cough illness. <unk> minute clinic today heard rales and sent her here for presumed pneumonia. on my exam she has coarse bs in l base but no clear focal rales. // eval for pneumonia
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In comparison with the earlier study of this date, the monitoring and support devices are unchanged. Again there are relatively low lung volumes. Bibasilar opacifications suggest effusions and compressive atelectasis. No definite vascular congestion or pneumothorax.
copd with hypertensive emergency.
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In comparison to the prior examination, there has been improvement in confluent airspace disease is well is interstitial markings, consistent with improved edema. Mild indistinctness of the pulmonary vasculature and possible septal lines may represent mild residual edema. The cardiac silhouette is unremarkable. A right-sided chest port is noted, terminating in the mid to low svc. There is no large pleural effusion or pneumothorax. Linear bibasilar opacities may represent bibasilar atelectasis.
history: <unk>f with syncope // infiltrate? fracture or bleed?
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Pa and lateral views of the chest were provided. The heart is moderately enlarged. There is no focal consolidation, effusion, or pneumothorax. Pulmonary ground-glass opacities seen on ct are less conspicuous on radiograph. Bony structures are intact.
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There is diffuse interstitial abnormality bilaterally which may be due to chronic pulmonary disease and/or pulmonary edema. Atypical infection not excluded. No large pleural effusion is seen. There is no pneumothorax.the aorta is tortuous. The cardiac silhouette is mildly enlarged.
history: <unk>f with sob wheezing past few days // r/o infiltrate chf
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Again seen is moderate decompensated congestive heart failure. The patient is now intubated and the endotracheal tube is appropriately positioned, approximately <num> cm above the carina. An orogastric tube terminates appropriately within the stomach. The study is otherwise unchanged.
evaluate positioning of endotracheal and other support lines.
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No previous images. There is mild fibrotic stranding in the right upper zone. However, no evidence of acute cardiopulmonary disease or tuberculous infection.
positive ppd.
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Again seen is extensive apical pleural calcifications bilaterally consistent with old tuberculous disease. Opacification in the left mid lung corresponding with previously demonstrated pneumonia with abscess in the lingular lobe has now decreased and likely represents fibrous scarring and healing from the pneumonia. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable.
<unk> year old woman with mac being treated now with cough for <num> weeks // rule out infiltrate,
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Linear left basilar opacity is most likely atelectasis. Lungs are otherwise clear without consolidation or large effusion. Posterior costophrenic ankle on the right is excluded from the field of view. Aortic core valve device is again seen. Mild cardiomegaly and tortuosity of the descending thoracic aorta is unchanged. Median sternotomy wires and mediastinal clips again noted.
<unk>m with cough // acute process?
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The et tube, ng tube, left subclavian line are unchanged. There is increased volume loss/ infiltrate and both lower lobes. There remainder the appearance the chest is unchanged
<unk> year old woman with ett, scla cvl, ogt, ? asp event // eval for interval change
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The patient is status post median sternotomy and cabg. A coronary artery stent is noted. There is biapical scarring with no focal consolidation, pleural effusion or pneumothorax. Coarsened lung markings are compatible emphysema as noted on prior ct. The cardiac, mediastinal and hilar contours are within normal limits.
<unk> year-old male with confusion.
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Portable ap upright chest radiograph was provided demonstrating no focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. No pneumothorax or pleural effusion. Bony structures are intact.
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Large mass adjacent to the aortic arch is consistent with aortic arch pseudoaneurysm previously imaged by chest cta in <unk>. Cardiac silhouette is enlarged and accompanied by mild pulmonary vascular congestion. New diffuse heterogeneous opacities in the right lung could reflect asymmetrical pulmonary edema or acute aspiration event, and note is also made of a new patchy opacity at the left base. Moderate right and small left pleural effusions are new.
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The cardiac, mediastinal and hilar contours appear unchanged. Projecting over the lateral right lung is a vague nodular focus, not present on the prior examinations. There is also a potential new lung nodule projecting over the left upper lung although the latter may be partly artifactual. There is no pleural effusion or pneumothorax.
tachycardia and chemotherapy.
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The tip of the endotracheal tube is situated just at the thoracic inlet <num> cm above the carina. There is atelectasis at the left lung base, although aspiration or pneumonia is another possibility. No focal consolidation is identified. The cardiomediastinal silhouette and hilar contours are normal. There is no pleural effusion or pneumothorax.
<unk>-year-old woman status post fall and intubation, evaluate for et tube placement.
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The cardiac silhouette is mildly enlarged. The aorta is calcified. Minimal basilar atelectasis is seen without definite focal consolidation. No pleural effusion or pneumothorax. No pulmonary edema.
history: <unk>f with altered mental status // acute cardiopulm disease
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Low lung volumes limits assessment as does multiple overlying wires. Patient is status post endotracheal tube placement which appears <num> cm above the level of the carina. An enteric tube traverses the thorax in an uncomplicated course. The heart appears top-normal in size. Mediastinal contour appears normal. Mild hilar prominence with perihilar opacity could reflect bronchovascular crowding, possibly aspiration or atelectasis. There is no large pleural effusion. No pneumothorax. Bony structures are grossly intact.
<unk>-year-old male status post endotracheal tube placement.
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As compared to the previous examination, the right pleural effusion has moderately decreased in extent. There is unchanged evidence of mild fluid overload, comparing to bilateral parenchymal opacities at the lung bases. Unchanged monitoring and support devices. Unchanged moderate cardiomegaly.
respiratory failure, evaluation for interval change.
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The cardiomediastinal and hilar contours are within normal limits. The lung fields are clear. There is no pneumothorax, fracture or dislocation. Limited assessment of the abdomen is unremarkable.
history: <unk>m with cp since this am. // acute cardiopulmonary process
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Single portable frontal chest radiograph demonstrates hypoinflated lungs with bilateral heterogeneous perihilar, interstitial and alveolar opacities with cephalization consistent with moderate pulmonary edema. Small bilateral pleural effusions. No pneumothorax. Mild cardiomegaly is present. Mediastinal contour is otherwise unremarkable. Aortic arch calcifications are present. Limited assessment upper abdomen is unremarkable.
tumor lysis syndrome with wheezing. assess for pulmonary edema.
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As compared to the previous radiograph, the patient has been extubated, the nasogastric tube and the swan-<unk> catheter have been removed. The bilateral chest tubes and mediastinal drains remain in place. A venous introduction sheath is seen in the left internal jugular vein. After extubation, the lung volumes have slightly decreased, with slightly increasing atelectatic changes at both lung bases. However, there is no evidence of substantial fluid overload or pleural effusions. No other parenchymal abnormalities. Unchanged moderate cardiomegaly.
status post cabg, follow up.
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Allowing for differences in technique and positioning, there has been slight interval worsening of bilateral diffuse heterogeneous lung opacities, particularly at the lung bases. Otherwise, no relevant change since the recent study.
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Lung volumes are somewhat low. The heart has increased in size from prior exam, the azygos vein is more prominent than on prior, and there is a new right pleural effusion, consistent with a volume overload state. There is an opacity at the right lung base, likely representing atelectasis given the short time course of development from prior. The opacity in the right medial lung likely represents the cardiac silhouette shifted due to patient rotation. The lungs are otherwise clear. There is no left pleural effusion or pneumothorax. A vp shunt is noted passing to the right chest.
history: <unk>m with coarse breath sounds, pre-op // eval for infiltrate
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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.
history: <unk>m with cough // please evaluate for acute process
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The lungs are clear without focal consolidation, effusion, or edema. Cardiac silhouette is top normal in size. Tortuosity of the descending thoracic aorta is noted with atherosclerotic calcifications at the arch. No acute osseous abnormalities identified.
<unk>f with weakness // please eval for pna
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Portable upright chest radiograph demonstrates a right central catheter, its tip which terminates at or just below the cavoatrial junction. Lungs are clear bilaterally. Cardiomediastinal and hilar contours are stable. There is no pneumothorax, pleural effusion, or evidence of pulmonary edema.
<unk>f with port // confirm placement of port
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Right sided dialysis catheter tip terminates in the low svc. Lung volumes are low. Heart size is normal. The mediastinal and hilar contours are unchanged. There is crowding of the bronchovascular structures, but no frank pulmonary edema is present. Previously noted patchy opacities in the right upper lobe have improved. There is worsening ill-defined opacification within the left lung base. No large pleural effusion or pneumothorax is demonstrated. Bronchial wall thickening is most pronounced within the left lung base and likely reflective of bronchitis. Areas of callus formation are noted involving multiple bilateral ribs. Partially imaged is fusion hardware within the cervical and thoracic spine.
shortness of breath.
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Tracheostomy tube appears unchanged in position. The lungs are clear. A few small granulomas are again seen in the chest as visualized on the prior ct from <unk>. Cardiomediastinal silhouette is normal. There is no pneumothorax or pleural effusion.
<unk>m with one day history of increased tenderness and swelling around t-tube, evidence of intrathoracic infection
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Heart is moderate to severely enlarged. Mediastinal and hilar contours are unremarkable. There is no pulmonary edema. No focal consolidation, pleural effusion or pneumothorax is seen. Minimal atelectasis is noted in the lung bases. Degenerative changes are noted throughout the thoracic spine as well as involving both acromioclavicular joints.
hypotension.
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The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The lungs appear clear. Bony structures are unremarkable. There has been no significant change.
shortness of breath and cough.
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Tip of endotracheal tube now terminates about <num> cm above the carina and could be advanced slightly for standard positioning. Cardiomediastinal contours are within normal limits. Bibasilar atelectasis and adjacent pleural effusions are slightly improved in the interval. However, a heterogeneous opacity in the right upper and mid lung region is new, and could reflect either a focus of aspiration or developing pneumonia in the appropriate clinical setting. Short-term followup radiograph may be helpful in this regard.
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Pa and lateral views of the chest provided.low lung volumes limit eval. There is no focal consolidation, effusion, or pneumothorax. No evidence of pulmonary edema. The heart size is top normal. The mediastinal contour is unchanged. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.
<unk>f with dyspnea, cp
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Comparison is made to prior study from <unk>. Hardware within the lower thoracic spine is seen. There is endotracheal tube whose tip is <num> cm above the carina. There is a feeding tube whose tip and side port are below the gastroesophageal junction. There is a left-sided picc line with distal lead tip in the distal svc. There is persistent cardiomegaly. There is mild pulmonary edema, stable. No focal consolidation or large pleural effusions are seen. There are no pneumothoraces.
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Cardiomediastinal contours are normal. Lungs and pleural surfaces are clear except for minimal linear atelectasis at the right base.
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As compared to the previous radiograph, there is no relevant change. No interval appearance of pneumonia. Mild overinflation, normal size of the cardiac silhouette, moderate tortuosity of the thoracic aorta without aneurysmatic dilatation. No pleural effusions. No lung nodules or masses.
cough, low-grade temperature, scattered wheezing, rule out pneumonia.
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Cardiac silhouette size appears mildly enlarged, increased compared to the prior study. The mediastinal contour is similar. Left picc tip terminates in the upper svc. There is mild pulmonary edema, new in the interval, with new layering small to moderate size bilateral pleural effusions. Bibasilar airspace opacities may reflect atelectasis, but infection or aspiration cannot be excluded. No pneumothorax is present. No acute osseous abnormality is detected.
history: <unk>m with chest pain, dyspnea
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Large cicatricial cysts in the lung apices, parenchymal scarring and architectural distortion are similar to the prior study. Lateral view suggests new material may have collected in one of the large cystic spaces, possible mycetoma. Volume loss at the lung apices with associated elevated of the hila is also unchanged. The pulmonary artery is newly enlarged, elevated, and lobulated. There is a new dense opacity in the left lower lobe and to a lesser extent at the right base. There is no pleural effusion or pneumothorax. The heart is not enlarged.
<unk> year old woman with severe pneumonia and resp failure in early <unk> // assess for degree of clearance of infiltrates emphysema, history of aspergillosis in the setting of bronchiectasis and cavitary lung disease.
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There is minor bibasilar atelectasis. No large pleural effusion is seen. There is no pneumothorax. The cardiac silhouette is mildly enlarged. Mediastinal contours are unremarkable.
history: <unk>f with chest pain // eval cardiomegaly
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Pa and lateral views of the chest. No prior. There is focal opacity in the right mid lung localizing to the middle lobe. The lungs are otherwise clear and there is no effusion. The cardiomediastinal silhouette is within normal limits. Osseous structures demonstrate no acute osseous abnormality.
<unk>-year-old female with cough and fever. question pneumonia.
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Portable ap upright chest radiograph obtained. The right-sided chest tube with tip pointing towards the right lung apex is in unchanged position. There is no significant change in loculated right pleural effusion. Suture material again noted in the right upper lung. There is right basal consolidation likely compressive atelectasis with the possibility of pneumonia not excluded. Left pleural effusion is unchanged. No change in loculated pleural effusions status post right chest tube placement.
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Ap single view of the chest has been obtained with patient in semi-upright position. Comparison is made with the next preceding similar study of <unk>, obtained <num> o'clock p.m. The present portable chest examination in this very obese patient creates limitations as it does not cover the entire right-sided base of the thorax. One can identify the tracheostomy cannula in place with its distal end properly aligned in the trachea, terminating some <num> cm above the level of the carina. No pneumothorax has developed. A right-sided picc line is seen as before and is overlying territory of the right atrium in its termination point. Withdrawal of the line by <num> cm is advisable so to be located in the mid portion of the svc and to avoid any interference with cardiac structures. No new pulmonary infiltrates can be identified. The left-sided lateral pleural sinus is clear from any fluid accumulation. No new parenchymal infiltrates are seen.
<unk>-year-old female patient with hcap, status post tracheostomy, evaluate for interval change.