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cardiac silhouette size is top normal. the aorta is tortuous. mediastinal and hilar contours are unremarkable. pulmonary vasculature is normal. minimal atelectasis is seen in the lung bases, and the lung volumes are low. no focal consolidation, pleural effusion or pneumothorax is present. moderate multilevel degenerative changes are seen in the thoracic spine. deformity of the seventh right lateral rib appears chronic. clips are noted within the upper abdomen.
history: <unk>m with fever
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bilateral lower lung plate-like atelectasis is minimally increased on the right from the prior exam. the lungs are otherwise clear. no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. stable cardiomediastinal silhouette and post-median sternotomy changes. stable eventration of the right hemidiaphragm.
<unk>-year-old man presenting with malaise; evaluate for pneumonia.
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prominent levoconvex scoliosis and absence of multiple left posterior upper ribs distort the thoracic cage but are stable since at least <unk>. the lungs are hyper-expanded, and the right diaphragm is flattened, consistent with chronic lung disease. no focal consolidation to suggest pneumonia. no pleural effusion, pulmonary edema, or pneumothorax. stable moderate cardiomegaly. stable appearance of the hila and mediastinum. diffuse bony demineralization, unchanged since at least <unk>.
<unk>-year-old woman presenting with cough and shortness of breath. evaluate for pneumonia.
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the heart is normal in size. the mediastinal and hilar contours appear within normal limits. bilaterally there small nodular densities that suggest nipple shadows., larger on the left than right. in addition there is a second nodular focus on the left which is round and measures approximately <num> mm which raises concern for potential parenchymal nodule. trace pleural effusions are present bilaterally. there is no pneumothorax. the finding of minimal fissural thickening may indicate slight fluid overload but there is no parenchymal edema.
hypotension.
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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.
<unk> year old man with l cp with arm numbness and ha for past month // cv abnormalities cv abnormalities
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right-sided port-a-cath is stable in position, terminating at the proximal right atrium. the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are stable.
history: <unk>f with confusion // eval infiltrate
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ap and lateral views of the chest. tracheostomy tube is seen in place. mild cardiomegaly is unchanged. there are bibasilar opacities that may represent atelectasis; however, aspiration or pneumonia cannot be ruled out. correlate clinically. no large pleural effusion or pneumothorax.
hypoxia, chronic tracheostomy, evaluate for acute process.
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cardiomediastinal contours are normal. the lungs are clear. there is no pneumothorax or pleural effusion. there are mild degenerative changes in the thoracic spine
<unk> year old man with cough for two weeks with fatigue // r/o pneumonia
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as compared to prior chest radiograph from <unk>, lung volumes are decreased accentuating the cardiomediastinal and hilar contours. endotracheal tube terminates <num> cm above the carina. there is a new right ij central venous catheter with its tip terminating in the distal svc. the heart is enlarged. there is collapse of the left lower lobe. bilateral opacities likely reflect a combination of pleural fluid and atelectasis. no evidence of free air in this frontal chest radiograph.
sepsis, recent bowel perforation, acutely hypotensive.
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frontal chest radiograph was provided for review. the cardiomediastinal and hilar contours are stable. again seen is a small left pleural effusion, much decreased compared to the most recent prior study. there is no right pleural effusion. there is no pneumothorax. there has been overall improvement in the bibasilar and right apical opacities since the most recent prior study. a tracheostomy tube is again noted in acceptable position. there has been interval removal of left internal jugular central venous catheter. again seen is a venous central line terminating near the inferior cavoatrial junction. contrast is seen in the stomach.
hypotension, altered mental status.
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bilateral chest tubes are in unchanged position. again, there are small bilateral pleural effusions. increased hazy opacification at the left base is likely due to redistribution of fluid from positioning, rather than an actual change in the amount of fluid. the left peripheral upper lobe opacity is unchanged. there is no new opacity or pulmonary edema. there is no pneumothorax. the cardiomediastinal silhouette is normal.
bilateral pleural effusions, status post chest tube placement. evaluate for change.
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no focal consolidation or pneumothorax is seen. there is blunting of the right costophrenic angle. heart and mediastinal contours are within normal limits.
<unk>-year-old female with cough, chest pain, and history of pulmonary embolus.
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again seen is a large right pleural effusion with a basilar atelectasis, not significantly changed from <unk>. mild left basilar atelectasis with blunting of the costophrenic sulcus is also unchanged. there is no pulmonary vascular congestion. the cardiomediastinal silhouette is stable. there is no pneumothorax.
multiple comorbidities with shortness of breath and chest pain and history of a large right pleural effusion.
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pa and lateral views of the chest. transvenous pacemaker leads end in the right atrium, right ventricle, and coronary sinus. one of the leads is broken proximally. aorta is calcified and tortuous but not dilated. lungs are clear without consolidation. heart, mediastinal and hilar contours are normal. no pleural effusion or pneumothorax. no evidence of pulmonary vascular engorgement or pulmonary edema. mild cardiomegaly.
bilateral lower extremity edema, evaluate for chf.
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the right pleural pigtail catheter is present. no discrete pneumothorax identified. there is a small right pleural effusion tracking along the lateral chest wall. right basilar atelectasis. there is a persistent prominence of the right hilum. the left lung is clear. the size of the cardiac silhouette is within normal limits.
<unk> year old man with cad, pneumothorax s/p chest tube, now with chest pain. // please evaluate for interval worsening of pneumothorax and ct placement.
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the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are normal. no pulmonary edema is seen.
cough.
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ap upright and lateral views of the chest provided. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no displaced rib fracture is seen. no free air below the right hemidiaphragm is seen.
<unk>m with fall r rib pain and r thigh pain // ? fx or ptx
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heart is normal size and cardiomediastinal contour is unremarkable. calcifications are again noted in the aortic arch. lungs are well-expanded and clear. there is no pleural effusion or pneumothorax. bones and the upper abdomen are grossly unremarkable.
<unk> year old woman with cough prod of green sputum // ? pneumonia
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the lungs are clear without focal consolidation, pleural effusion or pneumothorax. the heart is normal in size. normal cardiomediastinal silhouette. the heart was moderately enlarged on the prior study but has since normalized, suggesting in the setting of the acute illness on the prior study there was cardiac enlargement perhaps due to a pericardial effusion.
cough and history of pneumonia, assess for pneumonia.
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the cardiomediastinal contours are stable with normal heart size and aorta. a left exophytic hilar mass is unchanged in size since the chest radiograph from <unk>. there is no pleural effusion or pneumothorax. there is no new focal consolidation concerning for pneumonia. pulmonary vasculature is within normal limits.
metastatic lung cancer, now with rales through all lung fields.
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the cardiomediastinal and hilar contours are within normal limits. there is mild tortuosity of the descending aorta. there is mild calcification of the aortic knob. the lungs are well expanded and clear. there is no focal consolidation, pleural effusion or pneumothorax. note is made of fusion hardware along the lower thoracic spine.
dyspnea. rule out infection.
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the cardiomediastinal silhouette is normal. there is no pleural effusion or pneumothorax. no focal lung consolidation. no displaced rib fracture seen.
<unk>f with left chest wall pain after fall.
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there is a dilated small and large bowel most consistent with ileus. the distal portion of the ng tube is seen. images at different times were obtained. at <time>, the tip of the enteric tube ends in the stomach, the tip is apparently pulled back slightly on the <time> film; however, still ends in the stomach. extensive spinal hardware is seen with adjacent heterotopic ossification or bone graft material. no free air is identified.
ng tube placed for ileus, evaluate placement.
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the lungs are well expanded. there is increase in the interstitial markings, more pronounced in the right lung, with more focal patchy opacities throughout the right lower lung region. no focal opacities are noted in the left. there is no pleural effusion or pneumothorax. cardiomediastinal contours are unremarkable. tortuous aorta is redemonstrated.
<unk>-year-old male with cough and viral syndrome. evaluate for evidence of acute cardiopulmonary process.
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lung volumes are low leading to crowding of the bronchovascular structures. streaky bibasilar and right middle lobe airspace opacities l are noted. there is no large pleural effusion, pneumothorax, or frank pulmonary edema. the cardiac silhouette is mildly enlarged allowing for ap view.
history: <unk>f with sob and prod cough // eval pneumonia
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a new orogastric tube terminates in the lower part of the venous mediastinum, probably in the distal esophagus. otherwise, there has been no significant change.
new orogastric tube.
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left chest wall vagal nerve stimulator is noted. radiopaque component at the base of the neck, left appears slightly different in configuration when compared to prior compatible with interval surgery. streaky left basilar opacity may be secondary to atelectasis. the lungs are otherwise clear. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
<unk>m with generalized weakness, lethargy, poor historian // evidence of pneumonia
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the inspiratory lung volumes are decreased. the lungs are clear without focal consolidation, pleural effusion or pneumothorax. the pulmonary vasculature is not engorged. the cardiomediastinal and hilar contours are within normal limits and unchanged. no acute osseous abnormality is detected.
history: <unk>m with cp // eval ffor intrathorac process
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pa and lateral views of the chest provided. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
<unk>f with weakness, nausea // evaluate for pneumonia, acute process
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a tracheostomy tube is in position. a right-sided picc line terminates in the superior vena cava. there is a pigtail catheter projecting over the right hemithorax. there has been marked improvement in aeration of both lungs but with persistent opacification of the right lower lung suggesting residual atelectasis. confluent retrocardiac opacification is not specific but is also most often seen with atelectasis. it is difficult to exclude pleural effusions.
shortness of breath.
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compared with prior radiographs on <unk>, there is no significant change. a left chest wall pacemaker is stable in position, with leads terminating in the right atrium, right ventricle and his bundle. the right-sided picc line terminates in the mid svc. there is no pneumothorax. the lungs are clear without focal consolidation or pleural effusion. the cardiac and mediastinal silhouettes are unchanged. median sternotomy wires are stable in position. patient is status post avr.
<unk> year old woman with hf s/<unk> crt-d with leads in ra, rv and his bundle. cephalic access. // lead position, pneumothorax
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cardiac, mediastinal and hilar contours are normal. lungs are clear and the pulmonary vasculature is normal. no pleural effusion or pneumothorax is present. no acute osseous abnormality seen.
cough, shortness of breath.
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the lungs are clear. there is no pneumothorax. the right hemidiaphragm is eventrated. sternotomy wires are intact and aligned. a left pectoral pacemaker sends leads to the right atrium and right ventricle. incidentally, the right ventricular lead curves upward, as opposed to along the floor of the ventricle as is typically seen.
<unk> year old man s/p pacemaker // confirm lead placement
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et tube terminates <num> cm above the carina. ng tube terminates near the pylorus. extensive, bilateral alveolar opacities with improved aeration in the upper lungs bilaterally. increased distance between the left hemidiaphragm and intestinal gas suggests a possible left subpulmonic effusion. normal cardiomediastinal contours.
<unk>-year-old man with a history of heroin and benzodiazepine overdose. evaluate for interval change in diffuse opacities.
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the lungs are better expanded compared to the prior exam. no focal consolidation, effusion, pneumothorax, or edema. the heart is top-normal in size. the mediastinum is not widened. the hila are unremarkable. no acute osseous abnormality. again, a left sided device in the left lateral chest wall with wires tracking up to the neck are unchanged.
<unk>-year-old female presenting with seizure. evaluate for pneumonia.
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compared with the prior radiograph, lung volumes remain low, with unchanged moderate to severe cardiomegaly. small bilateral effusions are persistent. the left base is slightly better aerated, but a right basilar consolidation persists. no pneumothorax. multiple small metallic bbs are again seen in the soft tissues overlying the left chest.
<unk> year old man with s/p lap chole, now with rising wbc. evaluate for consolidation.
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frontal and lateral chest radiograph demonstrate well expanded and clear lungs without focal consolidation. there is no pleural effusion or pulmonary edema. the heart size is normal and hilar contour or unremarkable. no displaced rib fracture or rib lesion is identified. there are degenerative changes in the lower thoracic spine.
<unk>-year-old female with pleuritic chest pain. evaluate for intrapulmonary process.
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lung volumes are low. heart size is exaggerated as a result of low lung volumes and appears mildly enlarged. mediastinal and hilar contours are unremarkable. there is mild crowding of the bronchovascular structures without pulmonary edema. linear opacities in the lung bases are compatible with areas of atelectasis. no focal consolidation, pleural effusion or pneumothorax is present. mild degenerative changes are detected in the imaged thoracolumbar spine.
history: <unk>m with bradycardia
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pa and lateral views of the chest. no prior. the lungs are clear. there is no pneumothorax or effusion. cardiomediastinal silhouette is within normal limits. there is no evidence of pneumomediastinum. osseous and soft tissue structures are unremarkable.
<unk>-year-old male with chicken in esophagus. one-hour attempt to remove at outside hospital.
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frontal and lateral views of the chest demonstrate a transsubclavian right atrial and ventricular pacer defibrillator leads in standard position with no pneumothorax, pleural effusion, or mediastinal widening. lung volumes remain low. the heart is stably enlarged.
status post icd placement, assess for pneumothorax and evaluate lead position.
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the cardiac, mediastinal and hilar contours are within normal limits. the lungs are clear and the pulmonary vasculature normal. no focal consolidation, pleural effusion or pneumothorax is seen. no acute osseous abnormalities are demonstrated.
cough and fever.
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there is a right-sided central venous line with the distal lead tip in the distal svc. heart size is prominent but stable. lungs are grossly clear without focal consolidation, pleural effusions, or pulmonary edema. there are no pneumothoraces.
<unk> year old woman presenting with cough, ground glass on rll fields. // ? intra-thoracic abnl
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there are persistent multifocal opacities in the right upper, right lower, and left lower lung zones, all of which has increased from the prior chest radiograph. there is no pulmonary edema, pleural effusion, or pneumothorax. the cardiomediastinal silhouette is normal.
status post left lower lobe biopsy. evaluate for pneumothorax.
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lungs are well expanded. linear retrocardiac opacity is consistent with atelectasis. there is no pleural effusion or pneumothorax. the cardiomediastinal silhouette is top-normal in size, but there is no evidence of acute cardiac decompensation. there is a mild-to-moderate hiatal hernia.
history: <unk>f with persistent doe x <num> months // eval for acute process
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the heart is mild to moderately enlarged with dextro positioning. the aorta is moderate a mildly tortuous. there is a diffuse mild interstitial abnormality, probably due to mild pulmonary edema. lung volumes are low. there is no pleural effusion or pneumothorax.
altered mental status and right facial droop.
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a small amount of plate-like atelectasis is seen at the left base and stable. there is no consolidation or edema. there is no pleural effusion or pneumothorax. since the prior radiograph on <unk>, the t<num> vertebral body has a worsened compression fracture. in the previous exam, there is a mild compression deformity, but now it has lost greater than <unk>% of its height. the previously noted sternal fracture is in good alignment. there is diffuse demineralization and small lytic lesions in the remainder of the osseous structures, which is consistent with the patient's known multiple myeloma. the cardiomediastinal silhouette is normal.
multiple myeloma, shortness of breath and new hypoxia.
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mediastinal and hilar contours are unremarkable. there is stable mild cardiomegaly. lung volumes are low with bronchovascular crowding evident in the lung bases. no focal opacification concerning for pneumonia. no evidence of fluid overload. no pleural effusion or pneumothorax. sternotomy sutures are midline and intact.
fevers, evaluate for pneumonia.
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the heart size is within normal limits. the mediastinal and hilar contours appear unchanged. the previously described left pleural effusion is now markedly decreased. there is no pneumothorax. minimal left basal atelectasis persists but is improved from before.
<unk>-year-old male with pleural effusion status post thoracentesis.
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the heart size, mediastinal, and hilar contours are normal. the lungs are clear without pleural effusion, focal consolidation, or pneumothorax.
<unk>m with stroke/tia. evaluate for pneumonia.
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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.
<unk> year old woman with asthma exacerbation // ? pna
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patient is slightly rotated to the right. the lungs are clear. the heart size is normal. no pulmonary edema, pleural effusion, or pneumothorax. no focal consolidations are seen.
history: <unk>m with weakness, syncope // please eval for pna
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in comparison with <unk> study there is significant increase in volume loss of the left lung and mild leftward mediastinal shift suggestive of airway obstruction (mucous plugging). mild pulmonary vascular congestion is also seen. ett appears to terminate approximately <num> cm superior to the carina. a left picc line is unchanged in position and terminates at the mid svc. no pneumothorax is seen.
<unk> year old woman with cad.t<num>dm. pvd presents s/p cardiac arrest, diffuse anoxic brain injury on imaging intubated now with new desaturation // please assess for interval change in setting of acute desaturation
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left-sided the aicd/ pacemaker device is noted with leads terminating in the right atrium and right ventricle, unchanged. right port-a-cath tip terminates in the lower svc, unchanged. mild enlargement of the cardiac silhouette is again noted with left ventricular predominance. the mediastinal contour is unchanged with mild rightward deviation of the trachea again noted. extensive, chronic parenchymal opacities with architectural distortion and bronchiectasis are noted bilaterally, most pronounced in the right upper and left lower lung fields, not substantially changed in the interval, with slight increased atelectasis in the right upper lobe. remote right-sided rib fractures are again noted. no pneumothorax or pleural effusion is clearly evident. mild degenerative changes are again noted in the thoracic spine.
history: <unk>m with cystic fibrosis here with productive sputum, increased shortness of breath
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since the last chest radiograph performed earlier this morning, there has been interval expansion of the right-sided pneumothorax. this is particularly noticeable on the lateral and inferolateral aspect of the right lung, with no significant change in the right apex. no evidence of tension. the right chest tube is unchanged in position since the prior cxr. no other interval changes are noted. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
<unk> year old woman with pneumothorax // new pneumostat placement
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the lungs are hyperinflated, consistent with underlying emphysema. compared to the prior cxr in <unk>, there are new bilateral diffuse linear opacities, which are particularly prominent in the right apex. differential includes pulmonary vascular congestion vs. interstitial lung disease. additionally, cannot exclude underlying malignancy in the right apex. the cardiomediastinal silhouette is normal. there is flattening of the right hemidiaphragm. no acute osseous abnormalities.
<unk> year old man s/p fall with intracranial hemorrhages w/hx of desat and now coughing // r/o pulm edema vs. pna
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indwelling support and monitoring devices are stable and in appropriate position. mild cardiomegaly and pulmonary edema are stable. left basilar opacity likely representing a combination atelectasis and pleural effusion is unchanged from <unk>. no pneumothorax.
<unk> year old woman with as s/p tavr and hypoxemic respiratory failure // ?interval change
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the lungs are clear with no evidence of consolidation, effusion, or pneumothorax. cardiomediastinal silhouette is normal. no acute fractures are identified. there is no air under the hemidiaphragms.
abdominal pain.
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the patient is rotated somewhat to the left. previously seen right-sided picc is no longer seen. the patient is status post median sternotomy and cardiac valve replacements. there is a small left pleural effusion. trace right pleural effusion may also be present. there is mild to moderate pulmonary edema. the cardiac silhouette remains enlarged. the aortic knob is calcified.
shortness of breath.
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right middle lobe pneumonia continues to improve, when compared to the <unk> and <unk> cxr's. there are no new areas of consolidation, pleural effusion or pneumothorax. a small area of scarring in the right apex is again noted. small left pleural effusion is unchanged from prior. there is no pneumothorax. calcified granuloma is in the right mid and right lower lung are stable. no pneumothorax. the heart is enlarged, which was noted as far back as <unk>. no acute osseous abnormalities.
<unk> year old man for f/up on rml pneumonia // please re-assess lungs for complete resolution compared with prior cxrs showing only partial resolution of rml pna
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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.
fever and occasional cough.
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a new left ij central venous line has been placed and ends in the mid to upper svc with its tip pointing towards the lateral vessel wall. vascular congestion and pulmonary edema has worsened, and low lung volumes persist. the cardiac silhouette continues to be enlarged, and the <unk> and <unk> sternotomy wires are fractured.
<unk>-year-old female with left ij placement. evaluate placement.
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cardiomediastinal contours are normal. aside from linear scarring in the left base, the lungs are clear. there is no pneumothorax or pleural effusion. the osseous structures are unremarkable
<unk> year old man with cough and fever, please check for pna or other causes // <unk> year old man with cough and fever, please check for pna or other causes
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right basilar chest tube is again noted. there has been interval decrease in size of the right pleural effusion which is now small, with a trace left pleural effusion also noted. the heart size is mildly enlarged but unchanged. the aorta remains moderately tortuous with diffuse atherosclerotic calcifications. there is mild interstitial pulmonary edema which appears asymmetrically more pronounced on the right. streaky bibasilar opacities are likely reflective of atelectasis. no pneumothorax. no acute osseous abnormalities demonstrated.
recent pleurx catheter placement with rapid fluid accumulation.
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the heart is moderately enlarged. the hilar and mediastinal contours are within normal limits. moderate right and small left pleural effusions are stable since <unk>. a left-sided pleurx is unchanged in position. there is no pneumothorax or focal consolidation.
pain at the left pleurx catheter site.
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frontal and lateral views of the chest were obtained. left chest wall pacemaker leads are unchanged in position ending in the right atrium and right ventricle. heart size is top normal and unchanged. there is no focal consolidation. a right pleural effusion could be moderate in size if there is a subpulmonic component, which is suggested by the diaphragmatic contour. no left pleural effusion and no pneumothorax. pulmonary vasculature is normal. a <num>cm nodule projecting over the anterior second rib is unchanged from <unk> but not clearly seen on <unk>. degenerative change is noted in the spine.
pacemaker and dyspnea. evaluate for pulmonary edema.
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there is no focal consolidation, pleural effusion or pneumothorax. the cardiomediastinal silhouette is normal and unchanged. granulomatous calcifications in hilar lymph nodes are chronic.
palpitations, question acute process.
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frontal and lateral views of the chest were performed. there is no pleural effusion, pneumothorax or focal airspace consolidation. the cardiac and mediastinal contours are normal. the hilar structures are unremarkable. the known small pulmonary nodules are not well evaluated on this study. clips are seen within the upper abdomen.
hepatocellular carcinoma and altered mental status. evaluate for pneumonia.
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ap view of the chest provided. again seen is multi focal parenchymal opacities consistent with multi focal pneumonia. the left lung opacity has slightly increased since prior study, concerning for worsening disease. right svc line is in unchanged position in the low svc.
<unk> year old man with multi focal pneumonia, now acute hypoxia
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portable ap chest radiograph. ngt courses below the diaphragm and terminates outside the field of view. right ij catheter tip is in the right atrium. multifocal consolidations have continued to worsen, most notably in the right lung base. moderate bilateral pleural effusions have also developed in the interim. there is no pneumothorax. the cardiomediastinal silhouette is stable.
multifocal pneumonia and ards in the setting of cirrhosis.
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in comparison to the prior radiograph of <unk>, there is improved ventilation of both lungs. there may be small bilateral pleural effusions, better appreciated on the lateral view. no focal consolidations to suggest pneumonia. no evidence of pneumothorax or pulmonary edema. cardiomediastinal silhouette is within normal limits. the port-a-cath is unremarkable, and terminates at the expected location of the cavoatrial junction.
<unk> year old man with known metastatic pancreatic ca, chest ct <unk>-no lung mets.persistent cough for <num> weeks.bilateral crackles/ wheeze. // please eval for infiltrates
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pa and lateral views of the chest. there is no focal consolidation, pleural effusion, or pneumothorax. cardiomediastinal and hilar contours are normal.
cough for six weeks and shortness of breath.
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the cardiomediastinal and hilar contours are within normal limits. the lungs are clear without focal consolidation, pleural effusion or pneumothorax.
history: <unk>f with dyspnea // r/o acute process
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ap portable semi upright view of the chest. in the interval there has been placement of a left pigtail chest tube with slight decrease in left pleural effusion. no pneumothorax.
<unk> year old man with new l pleff s/p chest tube placement // r/o ptx
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again seen is cardiomegaly with low lung volumes and increased retrocardiac density with air bronchograms. mild vascular plethora may be accentuated by low lung volumes. overall, the appearance is similar to the film from <unk> at <time> p.m.. on today's study, the stomach is somewhat air distended. there are prominent air-filled loops of bowel in the upper abdomen. no free air is detected beneath the diaphragm on these views.
<unk> year old man with distended loops of bowel, impacted stool, worsening abdominal exam concerning for perforation // r/o free air under diaphragm, r/o pneumonia
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spinal hardware in place, stable. right port-a-cath in place tip low svc, similar. small left pleural effusion, more prominent. there is minimal left basilar atelectasis. indeterminate nodular opacity right lower lung medially, stable, better seen on ct abdomen pelvis <unk>. there is minimal right basilar atelectasis, similar. heart size, pulmonary vascularity within normal limits, improved.
<unk> year old woman with multiple myeloma with a fever to <num> and no localizing symptoms // ?pna or other acute process
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the cardiomediastinal and hilar contours are normal. the lungs are clear. there is no pleural effusion or pneumothorax.
<unk>-year-old female with left-sided chest pain.
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the heart size is normal. small left pleural effusion has increased in size compared to the prior exam. the hilar and mediastinal contours are stable. the lungs are otherwise clear without evidence of focal consolidations concerning for pneumonia. there is mild left basilar atelectasis. left-sided pacer leads are in appropriate position. the visualized osseous structures are unremarkable.
history of pleural effusions. please evaluate.
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no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. the heart size is normal. mediastinal contours are normal.
dyspnea and productive cough.
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single frontal radiograph of the chest demonstrates enlarged cardiac silhouette, increased compared to the prior. there is pulmonary vascular congestion and mild pulmonary edema. opacities in the bilateral mid lungs could represent atelectasis or edema although a superimposed infectious process is also possible. no large pleural effusions. no pneumothorax.
cough and hypoxia question pneumonia.
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the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.
history: <unk>m with upper chest tightness, dyspnea // eval for ptx
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pa and lateral views of the chest provided. there is no focal consolidation, effusion, or pneumothorax. cardiac enlargement is mild. no free air below the right hemidiaphragm is seen. symmetric biapical pleural thickening is likely post inflammatory. small nodular opacities are seen at the right apex and the left costophrenic angle warrant comparison to prior studies to assess for stability. in their absence, further imaging evaluation with ct may be indicated.
<unk>m with chest pain // eval for pna, cardiomegaly
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upright pa and lateral radiographs of the chest. the lungs are normally expanded and clear. the cardiomediastinal silhouette and hilar contours are normal. there is no pleural effusion or pneumothorax.
pancreatitis. rule out pleural effusion.
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a right-sided picc line can be followed up to the confluence of the brachiocephalic veins with the superior vena cava, somewhat more proximal than before. the cardiac, mediastinal, and hilar contours appear unchanged. the lungs appear clear. there is mild leftward convex curvature centered along the lower thoracic spine as before. bony structures are otherwise unremarkable.
malpositioned picc line.
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frontal and lateral views of the chest demonstrate airspace opacity predominantly in the right lung base, which is new since <unk>. there is no pleural effusion or pneumothorax. mild perihilar vascular congestion is noted. hilar and mediastinal silhouettes are otherwise unremarkable. heart size is normal.
hypoxia and rigors.
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chest, portable upright. there is mild pulmonary edema and bilateral lower lobe atelectasis. the lungs are otherwise clear. there is no pneumothorax or pleural effusion. the hilar and cardiomediastinal contours are unchanged from prior examination.
chest pain in a patient with a history of aortic dissection.
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pa and lateral views of the chest provided. left chest wall pacer device is again noted with leads extending into the region of the right atrium and right ventricle. there is opacity in the left lower lung which is concerning for pneumonia. also noted is a small left pleural effusion. the right lung is clear. cardiomegaly is mild. mediastinal contour is unremarkable. bony structures are intact. no free air below the right hemidiaphragm.
<unk>f with fever and cough
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the lungs are clear. there is no effusion or pneumothorax. the cardiomediastinal silhouette is within normal limits. no displaced fractures identified.
<unk>m after rear end collision // rule out pneumothorax or hemothorax
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ap upright and lateral views of the chest provided. lung volumes are low limiting assessment. allowing for low lung volumes and crowding of bronchovascular markings, no definite focal consolidation is seen. no large effusion or pneumothorax. cardiomediastinal silhouette likely within normal limits.
<unk>m with fever // acute process?
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there may be a new, heterogeneous ill-defined right lower lobe opacity. lungs are otherwise clear aside from minimal left apical scarring. heart is mildly enlarged. mediastinum is otherwise normal. hila and pleural surfaces are normal.
<unk>-year-old female with ongoing weight loss, hypertension, hyperlipidemia and diabetes <num>, assess for abnormality.
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right-sided port-a-cath is seen with catheter tip in the mid to lower svc. the lungs remain clear of focal consolidation, effusion, or edema. cardiomediastinal silhouette is stable. no acute osseous abnormalities.
<unk>m with hodgkins lymphoma with new cough and dyspnea // any pna
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a single portable semi-upright chest radiograph was obtained. cervical and thoracic fusion hardware is unchanged. a tunneled internal jugular central catheter terminates at the cavoatrial junction. right lower lobe consolidation is new since prior radiograph <unk> similar to ct chest from yesterday. small bilateral pleural effusions are not appreciated on this radiograph. cardiomegaly is mild.
<unk>-year-old man with hypoxia and mucus plugging, question pneumonia.
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a right-sided picc and dobhoff tube are unchanged in position when compared to the prior study. the cardiomediastinal contour and lung volumes are unchanged. no consolidation, pneumothorax or pleural effusion seen.
<unk>f hx of etoh abuse s/p fall with tbi, sdh, sah and left sphenoid sinus fracture, possible l posterolateral orbital wall fx, l temporal bone fracture. with component of vasospasm // rule out acute infection
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low lung volumes are present. the heart size is mildly enlarged. aortic knob calcifications are noted. left-sided indentation upon the trachea may be due to a left thyroid goiter or nodule. there is crowding of the bronchovascular structures with mild pulmonary vascular congestion. patchy opacities in the lung bases may reflect atelectasis. infection is not excluded in the correct clinical setting. trace left pleural effusion is not excluded. there is no pneumothorax. no acute osseous abnormality seen.
chest pain.
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the heart is at the upper limits of normal size. the mediastinal and hilar contours appear within normal limits. there is no pleural effusion or pneumothorax. the lungs appear clear. mild relative elevation of the right hemidiaphragm compared to the left appears stable.
right upper quadrant pain and rigors. history of cholangitis.
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lines and tubes: none lungs: moderately well inflated with bibasilar linear opacities, likely atelectasis. pleura: possible small left pleural effusion. no pneumothorax. mediastinum: unchanged cardiomegaly and mediastinal silhouette. bony thorax: diffuse osteopenia with unchanged appearance of right humeral prosthesis and metallic spinal stabilization hardware projecting over the lower cervical spine.
<unk> year old woman with hypoxia, pod<unk> s/p revision tka // please evaluate for acute process
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right lower lung consolidation and accompanying small pleural effusion is unchanged since <unk>. left lung is remarkable only for minimal left lower lung opacity likely atelectasis. as the patient is rotated assessment of the cardiomediastinal silhouette was limited. the lungs are clear. there is a chronic left glenohumeral joint dislocation.
<unk>-year-old woman with altered mental status. please evaluate for interval changes.
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since the prior study be swan-ganz catheter has been withdrawn and is now positioned centrally within the right main pulmonary artery. an intra-aortic balloon pump is unchanged in position compared to the prior study. moderate cardiomegaly and pulmonary vascular congestion persists without frank pulmonary edema. a right-sided picc terminates in the mid svc.
<unk> year old man with chf with iabp and swan. swan has been retracted // ?swan placement
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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 acute fracture is seen.
<unk> year old woman with back and chest pain // any e/o pna, bony lesions, aortic pathology?
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large right pleural effusion persists with associated lung volume loss. small left pleural effusion with basilar atelectasis is also seen. no pulmonary edema or focal consolidation is seen, and the cardiac and mediastinal contours are normal. a swan-ganz catheter is in appropriate position, and a nasogastric tube curls in the stomach. et tube is low in the trachea and is susceptible to malposition into a bronchus. intraperitoneal drain is seen in the right upper quadrant abdomen.
<unk>-year-old woman status post liver transplant. evaluate volume status.
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as compared to prior chest radiograph from earlier today, there has been interval placement of an endotracheal tube which terminates in the right mainstem bronchus. lung findings otherwise remain unchanged. there is no pneumothorax.
evaluation of et tube.