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mild cardiomegaly status post cabg, without acute chest abnormality.
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no evidence of acute cardiopulmonary process.
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bilateral pleural effusions with left basal atelectasis, cannot exclude pneumonia. probable underlying emphysema. additional chronic changes as described above.
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small pneumonia or chronic bronchiectasis, right upper lobe. two left upper lobe lung nodules could be infectious but need to be followed. recommendation(s): follow-up chest radiographs in <num> weeks following treatment are recommended to ensure resolution and to evaluate for persistence of left upper lobe nodules.
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no acute cardiopulmonary process. stable mild cardiomegaly and enlarged main pulmonary artery contour.
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complete resolution of right upper lobe pneumonia.
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findings suggesting mild pulmonary vascular congestion. patchy retrocardiac opacity for which atelectasis could be considered as the etiology, but pneumonia is not excluded. possible small left pleural effusion.
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bilateral perihilar and basilar opacities, compatible with pulmonary edema or bilateral pneumonia in the correct clinical setting. followup after treatment suggested.
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no acute cardiopulmonary process.
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interval improvement of the right lower lobe pneumonia.
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bibasilar airspace opacities may reflect atelectasis though infection cannot be completely excluded.
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patchy opacities in the right midlung and retrocardiac region are concerning for pneumonia.
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no evidence of intrathoracic metastatic disease.
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no acute cardiopulmonary abnormality.
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no focal consolidation to indicate new pneumonia. diffuse baseline bronchiectasis and probable fibrosis.
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in comparison with the study , the tracheostomy tube is unchanged. lung volumes have slightly increased. bibasilar opacifications most likely represent atelectatic changes with possible small effusions. however, in the appropriate clinical setting, superimposed pneumonia would have to be considered. the cardiac silhouette is at the upper limits of normal or mildly enlarged. indistinctness of pulmonary vessels is consistent with some elevation of pulmonary venous pressure, which appears to be improved.
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no acute intrathoracic process.
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in comparison with the study of , there is no evidence of acute cardiopulmonary disease. no pneumonia, vascular congestion, or pleural effusion. the increased opacification at the left base has completely cleared and the right ij catheter is been removed.
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no acute cardiopulmonary process. top-normal heart size.
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no definite acute intrathoracic abnormality.
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comparison to. stable position of the left picc line and of the tracheostomy tube. mild overinflation. no pulmonary edema. no pleural effusions. mild elongation of the descending aorta.
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the tracheostomy tube remains in satisfactory position with the tip approximately <num> cm above the carina. a right subclavian picc line has its tip in the proximal to mid svc. persistent consolidation at the lung bases, right greater than left, worrisome for pneumonia or aspiration. overall cardiac and mediastinal contours are stable. no pneumothorax. the patient is status post left mastectomy with surgical clips in the left axilla consistent with prior lymph node dissection.
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as compared to the previous study the pneumothorax has slightly decreased. left retrocardiac consolidation is present. there is no appreciable pleural effusion.
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patchy bibasilar airspace opacities, more pronounced on the left, may reflect areas of atelectasis, however, infection particularly in the left lower lobe cannot be excluded. decreased small left pleural effusion.
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no acute findings in the chest. please refer to subsequent cta chest for further detail.
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comparison to. no relevant change is noted. lung volumes are low. monitoring and support devices are stable. small right pleural effusion is unchanged. moderate cardiomegaly with retrocardiac atelectasis. mild to moderate pulmonary edema persists in virtually unchanged manner. and atelectatic opacity at the right lung basis is stable.
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interval increase in both right and left pleural effusions, now moderate to moderately large in size, with underlying collapse and/or consolidation. upper zone redistribution and mild vascular plethora is unchanged.
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no acute cardiopulmonary process.
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there is again seen a right-sided chest tube. there is a very tiny right apical pneumothorax which has decreased in size since previous. heart size is normal. there is a right basilar pleural effusion. the left lung is clear.
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mild interstitial pulmonary edema, worse in the interval, superimposed on a background of moderate emphysema. severe cardiomegaly and evidence of pulmonary arterial hypertension.
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no pneumothorax.
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normal chest radiographs.
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no acute intrathoracic process.
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no acute cardiopulmonary process
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extensive bibasilar consolidation developed between and , could be bilateral pneumonia or some component of atelectasis, in any case pointing to possible interval aspiration. since heterogeneous consolidation in the right lung has remained relatively stable, but there is much more consolidation in the left midlung and no improvement in the lower lobe. findings suggest widespread pneumonia in both lungs. heart is normal size but larger and mediastinal veins are distended indicating volume overload or biventricular heart failure as well. mild pulmonary edema would be difficult to appreciate independent of the pneumonia. left pic line ends low in the svc. et tube standard placement, and a nasogastric tube passes into the stomach and out of view
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moderate bilateral effusions and lower lung volume loss are worse compared to prior.
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no acute cardiopulmonary process.
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persistent regions of confluent consolidation in the right middle lobe and right suprahilar region, which could represent superimposed infection or atelectasis. findings are unchanged since. no acute cardiopulmonary process otherwise.
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subtle heterogeneous opacity in the lower posterior lung fields most clearly seen on the lateral view, worrisome for infection. results were discussed over the telephone with dr by dr at on at time of initial review.
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in comparison with the study of , there is little change and no evidence of acute cardiopulmonary disease. specifically, at the limits of plain radiology, there is no evidence of parenchymal metastases.
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no significant interval change. no acute cardiopulmonary process.
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pa and lateral chest compared to : normal heart, lungs, hila, mediastinum and pleural surfaces. no pneumonia.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process.
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as compared to radiograph, considering differences in technique and positioning, there has not been a relevant change in the appearance of the chest.
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bibasilar opacities are unchanged or worse suggesting recurrent aspiration, pneumonia, or less likely atelectasis.
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ap chest compared to at , read in conjunction with the subsequent chest radiograph no urgent or wet reading was requested with this examination. transverse diameter of the postoperative mediastinum has increased from approximately <num> cm, to <num> cm over six hours. small-to-moderate right pleural effusion has increased, with no pleural drain in the right hemithorax. two left pleural drains are unchanged in their positions at the apex and base, respectively, and there is little pleural effusion and probably no pneumothorax. diameter of the cardiac portion of the cardiomediastinal silhouette is normal and unchanged. tip of the right internal jugular line ends above the upper margin of the right clavicle, et tube is in standard placement and a nasogastric tube passes below the diaphragm and out of view. was paged at on when the subsequent chest radiograph was interpreted
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as compared to the previous radiograph, the patient was intubated. the tip of the endotracheal tube projects approximately <num> cm above the carina. the patient has also received the nasogastric tube. the course of the tube is unremarkable, the tip of the tube is not included on the image. the right internal jugular vein catheter is unchanged. in the interval, the patient has developed a severe left-sided perihilar opacities and minimal opacities in the right upper lobe. moreover, peribronchial opacities are also seen in the medial aspect 's of the right lower lobe. overall, the time course of the changes as well as the location is suggestive of an aspiration event or off unilaterally predominant pulmonary edema. no pneumothorax. no pleural effusions.
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ap chest compared to through : the mediastinal shift and persistent or recurrent consolidation in the right lower lobe suggest atelectasis and recurrent aspiration pneumonia. the left lung is clear. the heart is normal size. mediastinal veins are chronically dilated. pleural effusion on the right is small, increased since. there is no pleural effusion on the left and no indication of pneumothorax.
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mild interstitial pulmonary edema with bibasilar atelectasis and pleural effusions. no evidence of pneumonia or pneumothorax.
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no evidence of acute cardiopulmonary process.
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no acute cardiopulmonary process.
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unchanged mild hyperinflation, without acute chest abnormality.
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no evidence of acute cardiopulmonary disease.
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considerable calcification of the descending thoracic aorta, but no evidence of edema or pneumonia.
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no radiographic evidence of pneumonia.
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recurrence of a moderately sized right lateral pneumothorax. these findings were communicated via telephone by dr to dr at on , approximately <num> minutes after discovery.
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interval resolution of interstitial edema. small left pleural effusion.
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normal chest radiograph.
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increased opacity at the left lung base, probably consistent with increased volume loss superimposed on chronic scarring and atelectasis, although an infectious process is not excluded.
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possible mild pulmonary vascular congestion and streaky bibasilar airspace opacities, likely atelectasis.
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no acute intrathoracic process.
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normal chest radiograph.
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interval intubation, with the endotracheal tube terminating at the carinal. the tube can be pulled back approximately <num> cm to terminate in the mid thoracic trachea.
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no acute findings.
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no evidence of acute disease.
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no acute findings.
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no acute cardiopulmonary process.
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mild increase in left posterior basilar opacity, probably compatible with atelectasis, associated with a pleural effusion although infectious etiology is not excluded by this examination. stable small pleural effusions.
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endotracheal tube terminates <num> cm above the carina. swan-ganz catheter, orogastric tube and chest tubes appear in a good position. there is mild pulmonary vascular congestion. no pneumothorax is identified. there has been reduction in the fluid within the right minor fissure.
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resolution of pneumonia; no acute cardiopulmonary process.
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in comparison with the study of , there are improved lung volumes with no evidence of vascular congestion, pleural effusion, or acute focal pneumonia. there is some continued prominence of the pulmonary outflow tract. unless there is a murmur suggestive of pulmonic stenosis, this is probably merely a normal appearance in some young women. shoulder arthroplasty is again seen.
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as compared to the previous image, the pre-existing bilateral pleural effusions have completely resolved. the contours of the left and right hemidiaphragm are again sharp. borderline size of the cardiac silhouette. no pneumonia, no pulmonary edema.
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as compared to the previous radiograph, the lung volumes have increased, likely reflecting improved ventilation. borderline size of the cardiac silhouette without pulmonary edema. no pneumonia, no pleural effusion on both the frontal and the lateral image. the only new finding is a healing rib fracture on the right, at the level of the eighth rib.
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no acute cardiopulmonary abnormality.
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no acute intrathoracic process. no displaced fractures.
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no acute cardiopulmonary process.
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no acute cardiopulmonary abnormality. <num> mm nodular opacity projecting over the left eighth rib posteriorly. this could reflect a pulmonary nodule or a sclerotic focus within rib. comparison with prior chest radiographs would be helpful to determine the stability of this finding for alternatively bilateral oblique views.
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right hilar mass and post-obstructive atelectasis or pneumonia is again seen. no definite evidence of a rib lesion on these radiographs; however, on the most recent ct torso, a t<num> rib lesion may be appreciated. these findings were discussed by dr with the covering team at on by telephone.
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since the prior study there has been no substantial change or potentially even interval slight worsening of widespread parenchymal opacities. although there distribution might fever pulmonary edema, infectious etiology is a possibility and does assessment of the patient with chest ct especially if there is no response to diuresis would be beneficial to exclude underlying infectious process right picc line tip is at the level of cavoatrial junction
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widened appearance of the mediastinum likely due to unfolded thoracic aorta. aortic dissection cannot be excluded on a conventional radiograph, but there are no findings to suggest that diagnosis on this study.
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in comparison with the study of , there is little change and no evidence of acute cardiopulmonary disease. no pneumonia, vascular congestion, or pleural effusion.
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unchanged left apical pneumothorax.
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no focal opacity to suggest pneumonia. stable prominent interstitial markings, possibly due to chronic intersitial lung disease.
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in comparison with the study , there are slightly better lung volumes. the cardio mediastinal silhouette is stable and there is no evidence of vascular congestion or acute focal pneumonia. right ij port-a-cath extends to the cavoatrial junction or upper right atrium.
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ap chest compared to , : tip of the endotracheal tube has been partially withdrawn, now no less than <num> cm from the carina. nasogastric tube loops in the stomach ending in the fundus. mild-to-moderate cardiomegaly and mild pulmonary vascular congestion have both improved, and there is no pulmonary edema. greater opacification at the base of the left lung is probably a combination of persistent atelectasis and increasing small left pleural effusion. no pneumothorax.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process.
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no previous images. there are low lung volumes. bibasilar opacifications most likely reflect pleural fluid and atelectatic changes, more prominent on the right. in the appropriate clinical setting, the possibility of superimposed pneumonia would be difficult to unequivocally exclude, especially in the absence of a lateral view. several old healed rib fractures are seen on the right in there is a cervical fusion device in place. no definite vascular congestion.
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no acute cardiopulmonary process.
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interval increase in left pleural effusion and associated volume loss.
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small scar-like left upper lobe lesion is obscured by the chest cage and cannot be evaluated for subtle change with conventional radiographs. lungs elsewhere are clear. there is no pleural abnormality. heart size normal.
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interstitial edema and small right pleural effusion.
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bilateral pleural effusions and pulmonary edema. consolidative opacity in the right mid lung worrisome for pneumonia versus possible loculated pleural effusion with overlying lung collapse.
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no acute intrathoracic process.
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no acute process including no evidence of rib fractures.
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unremarkable chest radiographic examination.
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in comparison with the study , there is an placement of a left ij catheter that extends close to the junction with the subclavian vein. no evidence of pneumothorax. no significant change from the previous examination.
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heart size is exaggerated by low lung volumes and mediastinal fat had, probably top-normal. pulmonary vasculature is crowded but not dilated. there is no edema or consolidation and no pleural effusion. patient has had right upper lobe wedge resection and the surgery probably explains right pleural thickening.
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no evidence of acute cardiopulmonary abnormality.