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MIMIC-CXR-JPG/2.0.0/files/p16547190/s58239637/ed971eb4-29a72f82-25191857-573d1502-52d772e9.jpg
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the patient has been extubated. interval removal of the enteric tube. the right ij central venous catheter is in unchanged position. the transvenous pacer is position with tips terminating in the right atrium and right ventricle. the pulmonary edema and pulmonary venous congestion have improved slightly. bilateral lower lobe atelectasis and pleural effusions are unchanged. no pneumothorax. the cardiac silhouette is significantly enlarged, unchanged. the right tracheal indentation is seen after extubation, which is concerning for a thyroid lesion.
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<unk> year old woman with chf and ? pna // evaluate for interval change
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pa and lateral views of the chest demonstrate normal lung volumes. there is no pleural effusion, focal consolidation, or pneumothorax. the hilar and mediastinal silhouettes are unremarkable. heart size is normal. there is no pulmonary edema. partially imaged upper abdomen is unremarkable.
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patient with asthma and cough, assess for pneumonia.
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minor left base atelectasis/ scarring is seen. no focal consolidation is seen. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable. some degenerative changes are seen along the spine.
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history: <unk>f with confusion // eval for pna
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cardiac, mediastinal and hilar contours are normal. pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is present. no acute osseous abnormality is detected.
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history: <unk>m with chest pain
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heart size has increased from the prior study, now appearing mildly enlarged. the mediastinal contour is unchanged. diffuse alveolar opacities with perihilar haziness and vascular indistinctness is most compatible with moderate pulmonary edema. addition a there is a moderate left and small right bilateral pleural effusions, new in the interval. bibasilar airspace opacities may reflect compressive atelectasis, but infection or aspiration is not excluded in the correct clinical setting. no pneumothorax is seen. vascular calcifications are in the region of both axilla. there are no acute osseous abnormalities.
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history: <unk>m with altered mental status
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no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is detected. heart and mediastinal contours are within normal limits.
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<unk>-year-old female with cough and fever.
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the heart is mildly enlarged, unchanged from prior study. retrocardiac opacity in the left lung base could reflect atelectasis alone, however infection is not excluded in the appropriate clinical setting. right basilar atelectasis again seen. mediastinal and hilar contours are unchanged, with persistent prominence of the right hilum. there is interval progression of vascular congestion and pulmonary edema can currently be seen
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history: <unk>f with cough and sob // eval infiltrate
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interval improvement in the aeration at both lung bases with minimal residual left lower lobe atelectasis. no pleural effusion or pneumothorax identified. the size of the cardiomediastinal silhouette is enlarged but unchanged.
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<unk> yo f with hypothyroidism, dm, <unk> transferred from <unk> after being found down, transferred to micu for respiratory failure and pna s/p intubated <unk>, course complicated by <unk>/atn and delirium. ? brewing infection // ?acute intrapulmonary process
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portable upright chest radiograph <unk> at <time>
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<unk> year old woman receiving atg for aplastic anemia now with increasing dyspnea // evidence of any type of airspace disease including pneumonia, pleural effusion evidence of any type of airspace disease including pneumonia, pleural effusion
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single portable upright chest radiograph was obtained. note of made of a rightward shift of the trachea, new since prior examination dated <unk> that could a technical artifact due to low lung volumes and mildly lordotic positioning, but could also be the result of an increase in aortic caliber from aneurysm, pseudoaneurysm, or dissection. allowing for differences in technique, the cardiomediastinal and hilar contours otherwise remain stable when compared to prior study dated <unk>. subpleural opacities predominantly within the right upper lobe are more conspicuous on prior examinations. blunting of bilateral costophrenic angles may reflect bibasilar scarring or alternatively small pleural effusions. aforementioned findings are suggestive of pulmonary fibrosis. previously seen nodules on chest ct dated <unk> not obvious on several prior radiographs and additionally not well appreciated on current examination. no focal opacity convincing for pneumonia is identified. osseous structures demonstrate no acute abnormality.
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<unk> year old male with chest pain.
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there is a opacity in the right middle lobe, as well as one in the left lower lobe. this is most consistent with multifocal pneumonia. there is no pulmonary edema, pleural effusion, or pneumothorax. the cardiomediastinal silhouette is normal.
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cough and right lower lobe pleuritic chest pain. evaluate for pneumonia.
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the lungs are clear without focal consolidation, effusion, or edema. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
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<unk>f with chest tightness // eval for cp
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ap upright and lateral views of the chest provided. dual lead pacemaker is again noted with leads extending to the region of the right atrium and right ventricle. midline sternotomy wires are noted. there is extensive calcified pleural plaque in the left chest which accounts for the irregular opacity seen on radiograph. there is a small right pleural effusion with probable mild compressive lower lobe atelectasis. no large pneumothorax. heart size is top-normal contours unremarkable. bony structures are intact. inferior to left coracoid a well-defined ossific density is noted which reflect an old injury seen on ct.
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<unk>m with nasal packing and fever // ic abscess? pna?
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the heart is mildly to moderately enlarged with a left ventricular configuration. the patient is status post coronary artery bypass graft surgery. the aortic arch is calcified. the mediastinal and hilar contours appear unchanged. there is no pleural effusion or pneumothorax. similar mild relative elevation of the right hemidiaphragm is noted. healing right posterolateral fourth, fifth and sixth, and probably seventh rib fractures are noted. the degree of displacement is not significantly changed. slight interval sclerosis suggesting callus is seen compatible with ongoing healing process.
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congestion and cough.
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cardiomediastinal silhouette is within normal limits. lung volumes are low. lungs are clear. there is no pleural effusion or pneumothorax. old left rib fractures are noted.
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history: <unk>m with pmh cad s/p stenting c/o syncope // acute cardiopulmonary process
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frontal and lateral radiographs of the chest demonstrate normal heart size and hilar contours. stable tortuosity of the aorta. no pleural effusion or pneumothorax. clear lungs.
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chest pain. question pneumonia.
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the lungs are clear. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
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<unk>f with fever // evaluate for pneumonia
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the heart is at the upper limits of normal size with a left ventricular configuration. the lung volumes are low. the lungs appear clear. there is no pleural effusion or pneumothorax. a severe mid thoracic wedge compression deformity is unchanged.
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shortness of breath. history of multiple myeloma.
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severe emphysema is again noted. a metallic fiducial marker in the right upper lobe from prior biopsy is present. there is no pneumothorax, pleural effusion, pulmonary edema, or consolidation. known bilateral upper lobe nodules are better characterized on concurrently obtained ct. a cardiomediastinal silhouette is unremarkable.
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history: <unk>m with productive cough. // pna?
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single portable semi upright frontal chest radiograph demonstrates new left subclavian cvl tip within the mid svc. mildly hypoinflated lungs with perihilar interstitial prominence consistent with vascular crowding. stable reticular opacities within the lungs. no pleural effusion or pneumothorax. calcification of the left apical pleural surface again noted. no focal opacity. heart size, mediastinal contour, and hila are unremarkable. limited assessment of the osseous structures are unremarkable and upper abdomen is within normal limits.
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<unk>m with central line placement- subbclavian. assess for pneumothorax.
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single portable view of the chest. the lungs are clear of focal consolidation, large effusion, or overt pulmonary edema. the cardiac silhouette is stable in configuration given differences in technique. atherosclerotic calcifications are noted at the aortic arch. no acute osseous abnormality is identified.
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<unk>-year-old male with hypoxia.
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a background mild interstitial abnormality is unchanged from prior exams. linear opacities in the right lower lung are stable, and likely due to chronic atelectasis or scarring. there is no pleural effusion or pneumothorax. again noted is stable right-sided diaphragmatic eventration. the cardiac silhouette is severely enlarged, but unchanged from the prior exam. atherosclerotic calcifications are noted in the aortic arch.
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aortic stenosis and shortness of breath.
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the heart is normal in size. the mediastinal and hilar contours appear within normal limits. a calcified granuloma is noted in the mid right lung. the lungs appear otherwise clear. there are no pleural effusions or pneumothorax. surgical clips project over the right upper quadrant. no fracture is identified.
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status post atv crash with tenderness over the anterior chest wall.
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normal heart size, mediastinal and hilar contours. no focal consolidation, pleural effusion or pneumothorax.
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history: <unk>f with sudden onset epigastric pain radiating to back // eval for acute cardiopulm processeval for gallstones or cholecystitis
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patient is status post right middle lobectomy and right upper lobe wedge resection with clips noted at the right hilum. heart size is normal. the mediastinal contour appears similar with mild rightward shift of mediastinal structures reflective of the right-sided volume loss. fullness of the hila bilaterally likely reflects underlying lymphadenopathy, as noted on recent chest ct. pulmonary vasculature is not engorged. lungs remain hyperinflated with mild emphysematous changes again noted with an upper lobe predominance. chronic small right pleural effusion is unchanged with mild adjacent atelectasis in the right lung base. innumerable nodules within the lungs are progressed from <unk>, but not substantially changed from the previous chest ct. no new focal consolidation, left-sided pleural effusion or pneumothorax is present. no acute osseous abnormality is detected.
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history: <unk>m with weakness //pneumonia?
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in comparison to the chest radiograph obtained <num> day prior, there has been increased thickening of the minor fissure, likely extension of the otherwise unchanged, moderate, right pleural effusion. moderate cardiomegaly unchanged. pulmonary edema improved. a right-sided picc terminates near the origin of the svc.
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<unk> year old man with cad, chf with foot infection, <unk> not responding to diuresis, worsening volume overload, hypotension requiring pressor // evaluate for infiltrates, edema
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compared to priors, there has been no significant interval change. again seen is persistent opacity at the left mid to lower lung laterally, some of which is likely due to underlying pleural effusion. elsewhere the lungs are clear. cardiac silhouette is difficult to assess given silhouetting of the left cardiac border. atherosclerotic calcifications are noted in the thoracic aorta. elsewhere the lungs are clear.
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<unk>f with stroke // eval pna
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there is overall stable appearance of the chest from <unk> with loculated right pleural effusion extending over the apex and opacification of the right lower lobe which was demonstrated to be a postobstructive consolidation on the pet-ct yesterday. there is stable enlargement of the cardiac silhouette. no pneumothorax.
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<unk>f with metastatic lung ca and known right pleural effusion with dyspnea // assess for pna, worsening effusion
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a <num> mm pulmonary nodule is visualized within the right upper lung, which was previously visualized on the prior cts. the lungs are otherwise well inflated and clear. a moderate sized hiatal hernia with an air-fluid level is visualized. heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.
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<unk> year old woman with progressive exertional dyspnea // lung pathology
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as on prior, extremely low lung volumes are noted. left chest wall vagal nerve stimulator is again seen. the lungs are grossly clear. there is no effusion or obvious consolidation. cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
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<unk>m with cough // eval for pna
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a right ij central line is present, tip overlying distal svc at the cavoatrial junction. no pneumothorax is detected. the patient is status post sternotomy. there is prominence of the cardiac mediastinal silhouette, which is not significantly changed. patchy opacity at both lung bases, at least some of which is accounted for by atelectasis. blunting of the left costophrenic angle is consistent with a small effusion. there is minimal upper zone redistribution, but no overt chf. tiny metallic density again noted the left upper lung, question surgical clip. the lateral view shows an oblong opacity in the posterior segment of a lower lobe on one side. this is new compared with a ct dated <unk>.
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<unk> year old woman pod<num> cabg // evaluate for effusion/atelectasis
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the heart is normal in size. the mediastinal and hilar contours appear similar to earlier baseline radiographs. right basilar opacification has resolved. the lungs appear clear. there are no pleural effusions or pneumothorax. bony structures are unremarkable aside from minimal degenerative changes.
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altered mental status. history of hiv.
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low lung volumes cause bronchovascular crowding. pulmonary vascular congestion is mild. there is no focal consolidation, pleural effusion or pneumothorax. the cardiomediastinal silhouette, including top-normal heart size, is stable.
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<unk>f with altered mental status, likely dka, evaluate for acute process
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the patient is status post coronary artery bypass graft surgery. the heart is mildly enlarged. the mediastinal and hilar contours appear unchanged. there is no pleural effusion or pneumothorax. patchy opacity in the right lower lung is non-specific, but aspiration, pneumonia or substantial atelectasis could be considered.
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hypoglycemia. question aspiration.
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the patient is status post median sternotomy. a left chest wall single lead aicd is present as well as a left ventricular assist device. low bilateral lung volumes. there are bilateral hazy opacities in keeping with mild pulmonary edema. left lower lobe atelectasis.
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<unk> year old man with chf and lvad // evaluate for infiltrate vs consolidation
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there is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. the cardiomediastinal silhouette is within normal limits.
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<unk>f w/cough and chest tightness // <unk>f w/cough and chest tightness
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pa and lateral views of the chest provided. there is a feeding tube in place with its tip at the ge junction. advancement is recommended to ensure tip positioned in the stomach. lungs are clear. there is no focal consolidation, large effusion, or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
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<unk>f with fevers, sob // pna
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there is no chf, focal consolidation, pleural effusion or pneumothorax. cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities are identified. small amount of air beneath the left hemidiaphragm is not fully characterize, but could lie within the gastric fundus.
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history: <unk>m with chest pain // evidence of pneumo
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cardiac, mediastinal and hilar contours are normal. lungs are well expanded, with linear bibasilar opacities compatible with scarring, unchanged. no focal consolidation, pleural effusion or pneumothorax is present. there is no pulmonary vascular congestion. no free air is noted under the diaphragms. no acute osseous abnormality is detected.
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poorly controlled diabetes, abdominal pain, nausea, vomiting.
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lung volumes are low with bronchovascular crowding. moderate pulmonary vascular congestion. no effusion or pneumothorax. cardiomediastinal silhouette is unchanged. increased retrocardiac opacity suggests infectious etiology.
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<unk> year old man with hiv, fever of unknown origin and prior lll infiltrate seen on recent cxr - no pulmonary symptoms // ?infiltrate
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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.
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<unk> year old man with cough and fever // rule out infiltrate
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the right port-a-cath terminates in the mid svc. heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.
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<unk> year old woman with hx of mantel cell lymphoma d+<num> after auto transplant getting maintenance rituximab, worsening cough // pna?
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the patient is status post median sternotomy and cabg. heart is moderately enlarged but unchanged. the aorta is tortuous. the mediastinal and hilar contours are stable. the pulmonary vascularity is not engorged. no focal consolidation, pleural effusion or pneumothorax is identified. several clips are noted within the upper abdomen. mild degenerative changes are seen in the thoracic spine.
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cough and chest pain.
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median sternotomy wires are unchanged in position. bibasilar opacities are again noted, slightly improved on the left side when compared <unk>. there are small pleural effusions bilaterally. no evidence of pneumothorax. the heart size is within the upper limits of normal. the mediastinum appears normal.
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<unk> year old man s/p cabg // predischarge eval
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a vague opacity in the left lower lung is slightly more conspicuous compared with the prior exam. opacity previously noted in the right mid lung is less conspicuous, likely representing residual scarring in the area of prior pneumonia. no pneumothorax or large pleural effusion. heart size is stable and the mediastinal contour is unchanged. no displaced rib fracture.
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<unk>f with weakness, fall // eval for infiltrate
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portable supine chest radiograph was obtained. endotracheal tube terminates at the level of thoracic inlet, <num> cm above the carina. nasogastric tube courses into the stomach. the lungs are low in volume, giving the appearance of bronchovascular crowding. bibasilar streaky opacities likely reflect atelectasis. there is no pleural effusion or pneumothorax identified on this supine film. the heart and mediastinum appear unremarkable. non-displaced right second rib fracture is seen. possible right clavicular fracture with periosteal reaction is noted distally.
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intubation
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pa and lateral views of the chest. the lungs are clear. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormality detected.
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<unk>-year-old male with cough and shortness of breath.
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a portable ap supine radiograph demonstrates a new internal jugular sheath terminating in the upper superior vena cava. there is no pneumothorax. the examination is otherwise unchanged from the prior.
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<unk>-year-old woman with new right internal jugular cordis.
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ap semi upright portable chest radiograph provided. cardiomegaly is stable. there is mild improvement in the previously noted pulmonary edema. no large effusion is seen though the left lung base is poorly visualized. no pneumothorax. bony structures intact.
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<unk>f with fall, poor prior cxr.
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cardiomediastinal contours are normal. bibasilar atelectasis larger on the left have increased on the left. small left effusion has increased. there is no evident pneumothorax. there are low lung volumes. left rib fractures are better seen in prior ct.
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<unk> year old man with fall down stairs // eval interval <unk>
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lungs are clear of consolidation, pleural effusion or pneumothorax. there are streaky opacities at the left lung base, which most likely represent atelectasis. heart size remains mildly enlarged. no acute osseous abnormalities are identified.
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<unk> year old woman with h/o ger/asthma lpr/sinus issues now w worsening cough on therapy ? infiltrate . ? occult changes // <unk> year old woman with h/o ger/asthma lpr/sinus issues now w worsening cough on therapy ? infiltrate . ? occult changes
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in comparison to the most recent prior, a left internal jugular central venous catheter has been placed. the catheter terminates in the mid svc. again noted are low lung volumes. no new focal consolidation is identified. there is no pneumothorax. again seen is a possible diffusion on the right, unchanged since the prior examination. the cardiac silhouette is borderline enlarged and the pulmonary vascularity is indistinct, which may be suggestive of mild edema.
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<unk>m w/left ij placement, please confirm placement // <unk>m w/left ij placement, please confirm placement
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the heart size appears top normal, which may be exaggerated due to low lung volumes. the hilar and mediastinal contours are normal. the lungs are clear without evidence of focal consolidations concerning for pneumonia. there is no pleural effusion or pneumothorax. the visualized osseous structures are unremarkable.
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history of chest pain. please evaluate for pneumonia.
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heart size is mildly enlarged. the aorta is diffusely calcified. mediastinal and hilar contours are unremarkable. lungs are hyperinflated. ill-defined opacities are noted within both lung bases concerning for multifocal pneumonia or aspiration. no pleural effusion or pneumothorax is present. there are no acute osseous abnormalities. osseous structures are diffusely demineralized.
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history: <unk>f with cough x <num> days with scant bloody and sore throat for the past <num> days.
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the patient is status post sternotomy. a dual-lead pacemaker/icd device with leads terminating in the right atrium and ventricle, appears unchanged. the heart is again mild-to-moderately enlarged. a diffuse mild interstitial abnormality is suggestive of mild vascular congestion, but more focal opacities in the upper lungs have improved. a hazy appearance of the left lung base suggests a persistent pleural effusion as was seen on the prior radiographs and ct, which may also explain elevation of the left hemidiaphragm. the effusion and associated opacity have increased.
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altered mental status and recent pneumonia.
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there is a subtle field of radiodensity projecting over the right upper lobe between the anterior second and third ribs. it is uncertain if this is sequela of previous radiation treatment, if any, or an acute pneumonia. remainder of the lungs are unremarkable. there is no pleural effusion or pneumothorax. the cardiomediastinal silhouette is within normal limits. the pleural surfaces are unremarkable.
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<unk>-year-old female with cough and fever.
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a single portable ap chest radiograph was obtained. the enteric catheter follows the right lateral course through the gastric neo-esophagus. the tip of the enteric catheter terminates at the level of the diaphragmatic hiatus. esophagectomy staple line is unchanged. right lower lobe scarring and right basilar atelectasis have slightly increased. a minimal right apical pneumothorax is present. the left lung is clear. no effusion is present. cardiac and mediastinal silhouettes are unremarkable.
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<unk>-year-old woman status post hiatal hernia repair and possible entrance into the pleural space.
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lung volumes are within normal limits. the heart appears mildly enlarged with mild left ventricular enlargement. previous median sternotomy noted with surgical clips consistent with coronary artery bypass grafting. no consolidation, pneumothorax or pleural effusion seen. the visualized bony structures are unremarkable in appearance.
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<unk> year old man with nstemi and rising troponins // ?acute pulmonary process?
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the et tube is seen <num> cm above the carina, in stable position. there is again seen an ng tube or dobbhoff tube whose distal tip is not visualized below the lower limit of the film. left-sided central line is seen in stable position with distal tip projecting over the mid svc. there are again seen bilateral lower lung opacities, likely bilateral pneumonia. in comparison to prior radiograph, there is improvement in the right lower lung opacity. there is no pulmonary vascular congestion. there is no pneumothorax or effusion.
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<unk> year old man with ards // interval change
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portable ap upright radiograph of the chest was obtained. right-sided port-a-cath is unchanged in position. two left-sided chest tubes are apically directed without evidence of pneumothorax. trace pleural effusion is decreased. bibasilar atelectasis is noted. subcutaneous air is seen along the left flank. cardiomediastinal silhouette is unremarkable with surgical clips noted.
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<unk>-year-old woman with pain after left thoracoscopy, assess for residual pneumothorax.
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in comparison to the most recent prior study, there is increased opacification in the medial right lung base which may represent an early developing pneumonia in the appropriate clinical context but could also represent atelectasis. a large left juxtahilar mass is unchanged, corresponding to the patient's biopsy-proven small cell carcinoma, better characterized on recent ct of the chest. bilateral calcified pleural plaques are present. no significant pleural effusion or pneumothorax is detected. the pulmonary vasculature is not engorged. the cardiac silhouette is top normal in size but stable. the thoracic aorta is tortuous. the trachea is midline.
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hypotension, on chemotherapy, here to evaluate for acute cardiopulmonary process.
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the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac silhouette is top-normal to mildly enlarged. the aorta is slightly tortuous. degenerative changes are seen along the spine.
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cough and shortness of breath.
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heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. lungs are clear. scarring within the lung apices is unchanged. no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.
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history: <unk>f with palpitations
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shadows associated with bilateral breast implants are noted. the heart is normal in size. patchy calcification is noted along the aortic arch. the lungs appear clear. there is mild relative elevation of the right hemidiaphragm. there is no pleural effusion or pneumothorax. surgical clips probably due to cholecystectomy, project over the right upper quadrant. there is no free air.
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known ulcer with worsening pain. question free air.
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pa and lateral chest radiograph demonstrate clear lungs bilaterally. the heart is enlarged though similar in size relative to prior study dated <unk>. mediastinal and hilar contours are within normal limits. there is no evidence of pulmonary edema, pneumothorax, or pleural effusion. visualized osseous structures demonstrates no acute abnormality.
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<unk>-year-old female with presyncope and shortness of breath.
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lung volumes are low with bibasilar linear opacities compatible with atelectasis. small bilateral pleural effusions are also demonstrated. heart size appears unchanged and within normal limits. mediastinal and hilar contours are unremarkable. pulmonary vasculature is not engorged. the right hemidiaphragm remains elevated. azygos fissure is again noted. no acute osseous abnormality.
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<unk>-year-old male with a pmhx of mi s/p pci in <unk> and recent hospitalization here at <unk> for decompensated cirrhosis secondary to biopsy-proven nash and autoimmune hepatitis who was admitted with ascites, hepatic encephalopathy, and now developed a cough and tachycardia. // evaluate for interval change, infiltrate
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the heart size is normal. the hilar and mediastinal contours are normal. the lungs are clear without evidence of focal consolidations concerning for infection. there is no pneumothorax or pleural effusion.
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history of new onset chest pain, nonradiating in setting of an active pleural crohn's flare. please evaluate.
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ap view of the chest provided. as compared to prior study from <num> day ago, interstitial opacities throughout the right lung has increased. this mild asymmetric right pulmonary edema was also previously seen on <unk> scan. there is no lobar collapse. moderate amount of right pleural effusion is unchanged. right upper lobe pneumatocele size is unchanged, but there is perhaps less internal fluid component. cardiomediastinal silhouette is stable.
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<unk> year old woman with treacheomalacia s/p repair, evaluate interval change post bronchoscopy
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there is significant cardiomegaly with what appears to be significant atrial enlargement suggesting possible mitral valve disease. there is some pulmonary hyperinflation seen. there is a small right-sided effusion. pa pulmonary edema at this stage is minimal. left-sided pacemaker is in situ and
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<unk>m with congestive heart failure, atrial fibrillation on anticoagulation, copd and anemia who presents shortness of breath, likely chf exacerbation, improving with diuresis. // please assess for interval improvement in pulmonary edema
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cardiomediastinal silhouette is normal. there is no pleural effusion or pneumothorax. there is no focal lung consolidation.
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<unk>m with chest pain and palpitations.
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frontal and lateral chest radiographs demonstrate unchanged flattening of the hemidiaphragms consistent with copd. there is no focal consolidation, pleural effusion, or pneumothorax. the cardiac silhouette and mediastinal contours are normal. the pulmonary vasculature is normal. there is unchanged degenerative appearance of the thoracic spine.
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<unk>-year-old male with altered mental status, question pneumonia.
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heart size is mild to moderately enlarged. mediastinal and hilar contours are unremarkable. aortic knob calcifications noted. there is mild pulmonary vascular engorgement with small amount of fluid in the fissures and trace bilateral pleural effusions. streaky atelectasis is also noted in the lung bases without focal consolidation. posterior thoracic spinal fusion hardware is incompletely assessed.
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history: <unk>m with fever and shortness of breath
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frontal and lateral views of the chest were obtained. the lungs are well expanded and clear without focal consolidation, pleural effusion, or pneumothorax. heart size is normal. mediastinal silhouette and hilar contours are normal. no osseous abnormality is identified. there is no free air under the diaphragm.
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chest pain.
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a portable frontal chest radiograph shows the large left lower lobe mass seen on recent ct chest. new opacity adjacent to the aortic knob could represent pneumonia or fluid tracking up into the fissure. there is no appreciable pleural effusion or pneumothorax. the visualized upper abdomen is unremarkable.
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evaluate for infection, infiltrate, interval change in a patient with cough, shortness of breath, night sweats, and weight loss concerning for malignancy.
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pa and lateral views of the chest. the lungs remain clear of focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. no acute osseous abnormality is identified.
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<unk>-year-old female with chest pain.
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ap single view of the chest has been obtained with patient in semi-upright position. analysis is performed in direct comparison with the next preceding similar study <unk> <unk>. a tracheostomy cannula is in place, seen to terminate in the trachea <num> cm above the level of the carina. the position is unchanged. a right-sided picc line is noted, seen to terminate overlying the right-sided mediastinal structures at the level of the carina. this corresponds to the mid portion of the svc. there is no evidence of pneumothorax in the apical area. the heart size may have increased mildly in comparison with the previous portable chest examination, but this assessment is uncertain, considering portable technique and bedside examination resulting in geometric distortion. the pulmonary vasculature appears more crowded than before, but this is most likely related to patient's poorer inspirational effort with relatively high-positioned diaphragms. perivascular haze or central pulmonary edema cannot be identified on this portable examination. also, the lateral pleural sinuses are free from any major pleural effusion. no new acute discrete parenchymal infiltrates can be seen; however, the crowded appearance of the vasculature creates some linear structures on the bases most likely representing atelectasis. more older chest examinations are reviewed and it is noted that the patient had similar chest findings already on <unk> before the tracheostomy was performed. the picc line have been placed and identified on chest examination <unk> <unk>.
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<unk>-year-old male patient with intractable epilepsy with complicated course including femoral vein thrombosis, bi-coronal craniotomy, severely depressed mental status, respiratory failure, now transferred to the micu for further management.
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in comparison with chest radiograph from <unk>, bibasilar reticular opacities are minimally improved and, upon correlation with recent chest ct, could represent chronic interstitial disease. lungs are mildly hyperexpanded. minimal pleural thickening of the left apex is again seen. no new consolidation is seen. there is no pulmonary edema or vascular congestion. mediastinal and hilar contours are normal. heart is mildly enlarged and in the setting of prominent tissue markings, could represent chronic interstitial lung disease, pulmonary arterial disease or both.
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<unk> year old man with fever and cough // r/o new infiltrate
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cardiomediastinal contours are normal. the lungs are clear. there is no pneumothorax or pleural effusion. the osseous structures are unremarkable
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<unk> year old woman with hx positive ppd; believes may have had bcg vaccine in <unk>; living in <unk> since <unk> // hx positive ppd
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lungs are well-expanded and clear. no pleural effusion, focal consolidation, edema, or pneumothorax. heart size is normal. mediastinum is not widened. the hila and pleura are unremarkable. mild, broad dextroconvex scoliosis of the lower thoracic spine is unchanged.
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<unk>-year-old woman presenting with shortness of breath. evaluate for infiltrate.
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heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.
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history: <unk>f with chest pain, dyspnea
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the lungs are clear. the cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
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<unk>m with cp/epigastric pain // r/o pna
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dual lead pacer leads terminate in stable position. post cabg. cholecystectomy clips. accessed right porta catheter terminates in the ra. unchanged cardiomegaly. overall similar appearance of mild to moderate pulmonary edema. improved atelectasis of right lung base.
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<unk> year old woman with hfpef // eval for pulm edema/pleur effusions
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again noted is a large right-sided pleural effusion with concurrent severe atelectasis of the right middle and lower lobes. fluid is seen tracking into the right apex. the left lung and the right upper lung show no significan opacities. there is a trace pleural effusion on the left side that is mildly increased compared with <unk>. although the right heart border is obscured by above-mentioned abnormalities, the heart does not appear to be enlarged. the left hilar contours are unremarkable. there is no pneumothorax.
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<unk>-year-old man with history of cirrhosis and displayed ng tube. please assess for pneumonia or pleural effusion.
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one portable ap upright view of the chest. et tube ends <num> cm above the carina. left subclavian line ends in the right atrium. enteric feeding tube ends in the duodenum. the persistent bilateral opacities concerning for possible multifocal pneumonia are more apparent on this image compared to prior study.
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post-bronchoscopy desaturation, evaluate.
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evaluation is limited due to patient body habitus. there are bibasilar opacities, right greater than left, which may be representative of small layering pleural effusions or overlying soft tissue structures. the lungs are otherwise without a focal consolidation. mild cardiomegaly is stable. no acute fractures are identified.
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chest pain.
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a pacemaker projecting over the left axilla is re-demonstrated. two right ventricular, one right atrial and one left coronary sinus leads are unchanged in position compared with prior exam. sternotomy wires are intact. surgical clips are noted within the mediastinum compatible with prior cabg. lung volumes are low, accounting for bronchovascular crowding. there is prominence of interstitial markings, but no focal parenchymal opacities. the heart size is moderately to severely enlarged. the aorta is tortuous. there is no pleural effusion or pneumothorax.
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<unk>-year-old male pacemaker breakthrough through the skin. evaluate for lead migration.
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pa and lateral views of the chest provided. midline sternotomy wires and mediastinal clips are again noted. the lungs are clear without focal consolidation, large effusion or pneumothorax. there is a retrocardiac opacity containing gas most compatible with hiatal hernia. no large effusion or pneumothorax is seen. cardiomediastinal silhouette appears normal. bony structures notable for an acute left humeral neck fracture and dextroscoliosis of the t-spine.
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<unk>f with fall // pna? fracture?
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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.
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<unk>m with palpitations, question pneumonia.
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the heart size remains within normal limits. mediastinal and hilar contours are unchanged, with dilatation of the main, right, and left pulmonary arteries compatible with underlying pulmonary arterial hypertension. pulmonary vascularity is normal. lungs are clear. no focal consolidation, pleural effusion or pneumothorax is identified. scoliosis of the thoracic spine, convex to the right is noted.
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shortness of breath.
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patient is status post median sternotomy and cabg. left-sided aicd/ pacemaker device is noted with leads terminating in the regions of the right atrium, right ventricle, and coronary sinus, unchanged. heart size remains mildly enlarged. mediastinal and hilar contours are similar. lung volumes are low with diffuse increased interstitial markings with reticulation, most pronounced along the periphery and within the lung bases bilaterally. there is no pulmonary edema, new focal consolidation, pleural effusion or pneumothorax. no acute osseous abnormalities detected.
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history: <unk>m with new oxygen requirement
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the heart size is normal. the hilar and mediastinal contours are normal. there appears to be increased consolidation at the left lung base. there is no large pneumothorax or pleural effusion. no definite rib fractures are identified.
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history of rib fracture, status post fall with left rib pain. please evaluate.
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as compared to prior chest radiograph from <unk>, lung volumes remain unchanged. a left subclavian central venous catheter crosses midline and its tip terminates in the expected location of the right brachiocephalic vein. an endotracheal tube terminates <num> cm above the carina. an enteric tube courses below the diaphragm, its tip is in the gastric fundus. the cardiomediastinal and hilar contours are stable. lungs are essentially clear. there is no pneumothorax.
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<unk>-year-old man status post near drowning, requiring reintubation for dislodged et tube. evaluate et tube position.
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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.
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<unk>m with c/o cp // ? pna
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single lead left-sided pacer device extends to the expected location of the right ventricle.the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are stable. the aorta is calcified.
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history: <unk>m with cp // ptx?
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the lungs are well-expanded and clear. the cardiomediastinal and hilar contours are unremarkable. there is no pleural effusion, focal consolidation, or pneumothorax.
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<unk> year old woman with chest pain // r/o intrathoracic pathology
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no definite focal consolidation seen. subtle right base patchy opacity is similar to prior and thus most likely represents overlap of vascular structures. the left lung is clear. there is no pleural effusion or pneumothorax. the cardiac and mediastinal silhouettes are unremarkable. some degenerative changes are seen along the spine.
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history: <unk>f with <num> wk uri sxs now -> deeper chest sxs productive cough malaise // eval ? pna
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compared to the chest radiograph taken approximately <num> hours ago, there is no significant change. the et tube terminates approximately <num> cm from the carina. an enteric tube is seen below the diaphragm and out of view. the lungs are clear and there is no pleural abnormality. the hilar and mediastinal silhouette are unremarkable.
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history: <unk>m with pt thrashed, want to re-confirm placement*** warning *** multiple patients with same last name! // et tube position
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since <unk>, there has been an increase in the now large right pleural effusion and small left pleural effusion. moderate pulmonary interstitium edema is worse now. moderate cardiomegaly is unchanged in size. bibasilar atelectasis unchanged. concurrent pneumonia cannot be ruled out. pacer leads overlying right atrium and right ventricle.
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<unk> yo f with severe as, cad, <unk> on ckd with dyspnea // pna vs worsening pulmonary edema
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MIMIC-CXR-JPG/2.0.0/files/p16409774/s57966707/a7a9060b-9474b558-9363dd34-9017862b-56b174da.jpg
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the patient is status post cabg with sternotomy wires seen well aligned. there is stable, moderate cardiomegaly. significant bilateral interstitial pulmonary edema is seen with associated septal lines. there are bilateral pleural effusions, moderate of the right and mild on the left. there is a poorly defined opacity seen within the right middle and right lower lobes, and while this may be secondary to asymmetric edema, the localized distribution of the opacification suggests a potential pneumonia. there is no pneumothorax identified. the mediastinal contours are within normal limits. no bony abnormality is detected.
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shortness of breath and cough.
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MIMIC-CXR-JPG/2.0.0/files/p11235666/s52791609/2066d76b-c9a3a49c-99e2d74f-45a84d35-bdfeeb12.jpg
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ap and lateral views of the chest demonstrate the lungs are well expanded and clear. there is no pneumothorax, pleural effusion, pulmonary edema, or focal airspace consolidation. the heart is mildly enlarged, and a left chest wall pulse generator is present, with leads terminating in the right atrium and right ventricle. median sternotomy wires are present, and are intact. rightward convex scoliotic curvature of the thoracic spine is noted.
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<unk>-year-old man with weakness. evaluation for pneumonia.
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