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MIMIC-CXR-JPG/2.0.0/files/p14513402/s53920607/aa92b94c-cdb22a7f-e5616d2d-e57741cc-7502af77.jpg
slight improvement in pulmonary edema. otherwise unchanged.
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stable chest findings, no significant cardiac enlargement, no pulmonary congestion in this elderly male patient.
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in comparison with the study of , there are continued bilateral pulmonary opacifications. more coalescent areas in the right mid to upper zone as well as much of the left hemithorax raises the possibility of superimposed pneumonia in a patient with elevated pulmonary venous pressure. blunting of the costophrenic angles persists.
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no acute cardiopulmonary process. no rib fracture visualized.
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no acute cardiopulmonary process.
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compared to chest radiographs. lungs are fully expanded and clear. cardiomediastinal and hilar silhouettes and pleural surfaces are normal.
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in comparison with the study of , the cardio mediastinal silhouette is unchanged. there are lower lung volumes. indistinctness of engorged pulmonary vessels is consistent with developing pulmonary edema. the left hemidiaphragm has been obscured, consistent with pleural fluid and volume loss in the left lower lobe. the remainder of the study is essentially unchanged.
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no acute cardiopulmonary process. no cardiomegaly.
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pa and lateral chest compared to preoperative chest radiograph, and postoperative on : moderate left and small right pleural effusions, both increased minimally since. stable mild enlargement of postoperative cardiac silhouette. tiny left apical pneumothorax unchanged. moderately severe left lower lobe atelectasis has improved. there is no pulmonary edema.
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no evidence of pneumonia or traumatic injury.
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interval improvement in right base opacity, though a small amount of residual opacity remains visible at the right base. persistent left base opacity is similar. small right-greater-than-left effusions again noted, also similar to prior.
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no acute cardiopulmonary process.
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no acute cardiopulmonary abnormality.
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no acute cardiopulmonary pathology.
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no acute cardiopulmonary process.
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no pneumonia.
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mild pulmonary edema.
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no acute cardiopulmonary process.
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right internal jugular central venous catheter with its tip projecting over the low superior vena cava. no pneumothorax.
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increased bibasilar opacities, which likely represents a developing pneumonia. recommend follow up chest radiographs in weeks following the completion of antibioic therapy to document resolution. stable biapical emphysematous changes. findings were communicated by dr to dr telephone at am on , <num> minutes after discovery.
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no acute cardiopulmonary pathology.
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no radiographic evidence for acute cardiopulmonary process.
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increased left base consolidation is concerning for aspiration pneumonia.
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improving bibasilar aeration with faint residual right lower opacity consistent with resolving pneumonia.
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large pericardial effusion. moderate left pleural effusion with adjacent atelectasis. small right pleural effusion.
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no acute intrathoracic process
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no evidence of pneumonia. -mm nodular density in left first interspace, unchanged since at least , which is reassuring.
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new small right pleural effusion with improvement in bibasilar atelectasis. no other acute abnormality.
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no acute cardiopulmonary process.
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compared to chest radiographs through at. moderate left pleural effusion is larger. small right pleural effusion unchanged. likely left lower lobe atelectasis has worsened. upper lungs clear. heart size normal. feeding tube passes into the stomach and out of view. left pic line ends in the low svc. no pneumothorax.
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comparison to. decrease in severity of the pre-existing pulmonary edema that is still mild to moderate. decrease in extent of a pre-existing retrocardiac atelectasis. mild cardiomegaly persists. no pleural effusions. no new focal parenchymal changes. the feeding tube is in stable position.
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no evidence of acute disease.
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there has been interval removal left-sided chest tube. no pneumothorax. small bilateral pleural effusions are stable from earlier today. no pulmonary edema. left perihilar opacity and sutures are consistent with postsurgical change. mediastinal contours and cardiac silhouette are normal.
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in comparison with the study of , there again is almost complete opacification of the left hemithorax despite a pigtail catheter in place. little change in the degree of shift of the mediastinum to the right. pulmonary vascular congestion may be more prominent than on the previous study.
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fluid is accumulating in the chronic left anterior pneumothorax, persisting since left upper lobectomy, smaller since. there is a smaller air and fluid pleural loculation posteriorly, seen best on the lateral view. right lung is clear. hemidiaphragm is elevated today relative to and there is greater separation between air in lung and air in the stomach. this could be due to to fluid loculated in either the left subdiaphragmatic pleural space along the left hemidiaphragm, or in the left upper abdominal quadrant. right lung is grossly clear. mediastinum shifted slightly to the left.
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no acute intrathoracic process.
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mild left lower lobe opacity is suspicious for pneumonia.
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new infiltrate in the lingula is concerning for pneumonia.
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resolving right lower lobe pneumonia. chronic obstructive airways disease.
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no acute cardiopulmonary process.
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right picc line tip is at the level of mid svc. cardiomediastinal silhouette is unchanged. bilateral pleural effusions are present, substantial. mild vascular enlargement is noted. there is no pneumothorax.
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no pneumothorax. icd leads are in the expected positions.
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opacification within the right mid and lower lung fields likely reflects a combination of a moderate pleural effusion and right basilar atelectasis, though infection or aspiration cannot be excluded.
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compared to chest radiographs and. the upper paramedian chest has a very abnormal appearance, suggesting either a very large esophageal hernia or prior esophagectomy and gastric pull-up surgery or hilar or lung masses, mucoid impactions or fissural pleural fluid loculations. unfortunately the explanation is not clarified by the lateral view and ct scanning is recommended if the accurate clinical history is not known. thickening of the left lateral costal pleural margin and deformity of the adjacent ribs suggest prior trauma, perhaps recent. heart is moderately enlarged. i do not see pneumonia or pulmonary edema and pleural effusion if any is small. no pneumothorax. left pic line ends in the mid svc.
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no signs of pneumonia.
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no acute cardiopulmonary abnormality.
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no evidence of acute cardiopulmonary disease.
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no acute cardiopulmonary process.
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tracheostomy is in place. right picc line tip is in the right atrium and should be pulled back <num> cm to secure it position at the cavoatrial junction or above. cardiomediastinal silhouette is unchanged. postsurgical changes in the left upper lung and in the right hemithorax are unchanged. old rib fracture on the right is unchanged. left pleural effusion is moderate, unchanged. right pigtail catheter is similar in location as compared to previous examination.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process.
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no radiographic evidence of pneumonia or other significant cardiopulmonary abnormalities.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process.
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no acute findings in the chest.
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no acute intrathoracic process.
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mild to moderate interstitial edema. no pneumonia.
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no acute cardiopulmonary process.
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increased bibasilar opacities, likely atelectasis.
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compared to chest radiographs. low lung volumes persist. mild pulmonary edema, best appreciated in the left lung has worsened. that may account for areas of increasing peribronchial opacification in the right lung as well. pneumonia or aspiration are not excluded. heart size is normal. mediastinal veins are mildly dilated and upper lobe pulmonary vasculature is engorged.
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new, left retrocardiac opacity may reflect atelectasis or pneumonia, in the appropriate clinical setting.
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no acute cardiopulmonary process.
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no acute cardiopulmonary abnormality. chronic focal opacity within the right lower lobe, previously seen on prior ct, and unchanged from the previous radiograph.
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no evidence of pneumonia.
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no previous images. no evidence of acute pneumonia, vascular congestion, or pleural effusion. of incidental note is a mild pectus.
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no evidence of pneumonia.
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suspected trace new left-sided pleural effusion; otherwise unremarkable.
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small bilateral pleural effusion with overlying atelectasis, underlying consolidation not excluded. additionally, there may be partial collapse of the right middle lobe, similar compared to prior, with related pleural effusion.
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moderate right pleural effusion decreased between and has been stable subsequently. it is largely dependent but, probably loculated to some extent. severe enlargement of cardiac silhouette is stable. pulmonary vascular engorgement has worsened, but there is no edema. right lower lobe is partially obscured by the pleural effusion and no doubt new partly atelectatic. as such i cannot exclude pneumonia in that location, but elsewhere the lungs are clear. there is no pneumothorax. the right pectoral generator issues two trans subclavian leads, one terminating in the right atrium and the other, without a tip electrode, at the level of the superior cavoatrial junction. a sub xiphoid lead is company by a second fragmented lead, both terminating at the margin of the right atrium. the third sub xiphoid lead terminates along the floor of the right heart, fourth, along the diaphragmatic surface to the left of the midline, and if fifth, left of the midline at the base of the heart. in all of these intact and fragment leads are unchanged in position since at least.
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no evidence of pneumonia.
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no significant interval change. moderate right and small left effusion. underlying consolidation, particular at the right lung base would be difficult to exclude.
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appropriately positioned et and ng tubes.
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there to chest radiographs through. previous severe pulmonary edema has almost cleared. moderate right pleural effusion remains. opacification in the left lower lobe which developed between and is probably atelectasis and there is a small accompanying left pleural effusion. heart size is normal. no pneumothorax. cardiopulmonary support devices are in standard placements.
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no opacification concerning pneumonia. stable faint opacification projecting ober left lower lung may reflect small left pleural effusion.
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multifocal consolidative opacities concerning for multifocal pneumonia. followup radiographs after treatment are recommended to ensure resolution of these findings.
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substantially decreased, now small, left pleural effusion status-post left chest tube placement. no pneumothorax.
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low lung volumes is expected following surgery, reflected in bibasilar atelectasis. no pneumothorax, appreciable pleural effusion, right pleural tube in place. no evidence of hemorrhage. heart size is mildly enlarged, exaggerated by low lung volumes and ap projection.
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et tube in lower trachea. withdrawal by a <num> cm is advised for more optimal ventilation. no other significant interval change.
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large anterior mediastinal mass. further assessment with contrast-enhanced ct is recommended.
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no acute intrathoracic process identified.
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allowing for differences in technique and positioning, there has been little interval change in the appearance of the chest since the recent study of <num> day earlier, except for slight worsening of bibasilar atelectasis.
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stable examination. no evidence of pulmonary edema.
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comparison to. no relevant change. complete opacification of the left hemi thorax with leftward shift of the mediastinum. unchanged appearance of a relatively subtle right basal parenchymal opacity. the position of the right internal jugular vein catheter is stable.
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mild congestive heart failure and small bilateral pleural effusions. bibasilar atelectasis.
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no acute cardiopulmonary process.
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no evidence of acute disease.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process.
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mild interstitial abnormality suggesting slight fluid overload. crowding of right basilar lung markings, more suggestive of minor atelectasis than pneumonia. however, if pneumonia is a persistent clinical concern, then short-term followup radiographs may be helpful, preferably with pa and lateral technique, if possible. severe lower thoracic compression deformity, age-indeterminant on radiography, but with not clear indication of recent chronicity. correlation with clinical presentation and findings is suggested.
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improved ventilation with reduction of pulmonary edema and reduced right base atelectasis.
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no acute cardiopulmonary process. there is persistence of hypoinflated lungs, which is unusual in the setting of copd and may represent an underlying interstitial lung disease. if there is continued clinical concern, a dedicated ct exam could be helpful for further evaluation.
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ap and lateral chest compared to. there is no pneumonia or atelectasis. small bilateral pleural effusions are present. heart size normal. right pic line ends in the upper svc.
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new right upper lobe infiltrate
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no acute intrathoracic process.
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interval removal of support lines and tubes with small left pleural effusion. new curvilinear density projecting at the level of the right hemidiaphragm of indeterminate etiology. repeat upright radiograph today is recommended to exclude pneumothorax. findings discussed with by by phone at on after attending radiologist review.
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no overt evidence for pneumonia or pulmonary edema.
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no evidence of acute disease.
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left lower lobe atelectasis small effusion.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process. possible left <num>th rib fracture posteriorly, recommend dedicated rib films for better evaluation.