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MIMIC-CXR-JPG/2.0.0/files/p16865871/s50830615/6520217f-d00d36ae-a55b165c-6d78b2a9-2d6cc885.jpg
increased soft tissue thickening along the medial right upper mediastinum may be related to patient rotation. ap and lateral radiographs are recommended, ensuring no patient rotation. findings were communicated via phone call by to at on.
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no acute cardiopulmonary process. chronically top normal sized heart.
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no radiographic evidence of pneumonia.
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resolved left pleural effusion; improved, now small right pleural effusion. edema is better, now mild.
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borderline cardiomegaly. otherwise, normal.
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worsening mild-to-moderate pulmonary edema with increased small bilateral pleural effusions. unchanged moderate cardiomegaly.
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no acute cardiopulmonary process. persistent elevation of the right hemidiaphragm.
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cardiomegaly without definite acute cardiopulmonary process.
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no acute cardiopulmonary process. heart size top normal. no pneumothorax.
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right lower lobe pneumonia.
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low lung volumes with persistent bibasilar atelectasis.
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no acute cardiopulmonary process.
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vague peribronchial opacity projecting over the anterior left rib. follow-up radiographs suggested in <num> weeks. findings were emailed to the ed qa nurses at on
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comparison to. the feeding tube was changed. the course of the new tube is unremarkable, the tip projects over the middle parts of the stomach. a left port-a-cath is in unchanged position. bilateral ureter stents as well as a vena cava filter are visualized. mild cardiomegaly with minimal retrocardiac atelectasis is stable.
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right lower lobe pneumonia.
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as compared to the previous radiograph, there is an increase in vascular structures around the left hilus, potentially suggestive of fluid overload. in addition, there is a constant opacity in the right lower lobe, likely reflecting an pneumonia. the size of the cardiac silhouette is unchanged. unchanged monitoring and support devices.
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no acute cardiopulmonary process. air in the esophagus may reflect esophagitis.
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tunneled dialysis line in unchanged position ending in the right atrium.
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now moderate pulmonary edema has markedly worsened. there are low lung volumes. right lower lobe atelectasis has increased. cardiomegaly and widened mediastinum are unchanged. there is no pneumothorax. ng tube tip is out of view below the diaphragm
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no relevant change as compared to the previous image. unchanged single lead, with the tip projecting over the right ventricle. no pneumothorax. mild cardiomegaly without pulmonary edema.
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no evidence of acute cardiopulmonary abnormality.
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no focal consolidations concerning for pneumonia identified.
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as compared to the previous image, the endotracheal tube has been advanced. the tip of the tube projects <num> cm above the carina and should be pulled back by approximately <num> cm to avoid intubation of the right main bronchus. slight increase in extent of a pre-existing left basilar atelectasis. unchanged left chest tube. unchanged moderate pulmonary edema and moderate to severe cardio megaly.
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no evidence of acute disease.
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stable changes of chronic interstitial lung disease without evidence of a superimposed acute cardiopulmonary process.
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no significant interval change in evolving septic emboli and bilateral hilar lymphadenopathy.
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no acute intrathoracic process.
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no acute intrathoracic abnormality.
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no evidence of focal consolidation. stable right paratracheal mediastinal bulge, due to known mediastinal cyst. stable fracture of the mid shaft of the left humerus.
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ap and lateral chest compared to : small-to-moderate bilateral pleural effusions have both decreased substantially since and previous mild pulmonary edema has cleared. lung volumes have improved. moderate-to-severe cardiomegaly and a large partially fluid filled hiatus hernia are chronic. incidental note is made of heavy calcification of the mitral annulus, which in some patients contributes to mitral regurgitation.
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as compared to the previous image, the left-sided picc line is still malpositioned in the right subclavian vein. the line has barely changed since the previous examination. low lung volumes continue to be present. moderate cardiomegaly. the pre-existing opacity at the right lung bases is less extensive than on the previous image.
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subtle opacities in the right mid lung, less conspicuous than on. again, this finding may represent pneumonia and follow up radiographs to resolution are advised.
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small bilateral pleural effusions are mildly increased with associated bibasilar atelectasis.
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<num> left chest tubes are in place. apical pneumo on the left is unchanged. sutures are unchanged. right basal atelectasis is unchanged. overall stable appearance of the chest.
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there are left greater than right basilar opacities most conspicuous at the left costophrenic angle, some of this was present on prior although is more conspicuous on the current exam and may represent active disease versus scar or atelectasis.
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no appreciable change in degree of mild vascular congestion.
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emphysema. no acute cardiopulmonary process.
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interval decrease in size but residual small to moderate right pleural effusion status post thoracentesis. no pneumothorax. heart remains stably enlarged which may reflect cardiomegaly, although pericardial effusion should also be considered. mediastinal contours are stable. calcification of the aorta consistent with atherosclerosis. no evidence of pulmonary edema. streaky opacities at the left base and more focal patchy opacity at the right base likely reflect atelectasis, although superimposed pneumonia cannot be excluded.
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mild cardiomegaly with probable mild pulmonary edema. no new focal lung consolidation. chronic loculated left pleural effusion and rounded atelectasis.
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left lateral ninth rib fracture identified with likely adjacent atelectasis. no pneumothorax seen.
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normal chest radiographs.
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no acute cardiopulmonary process.
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lungs clear
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bilateral moderate pleural effusions, right greater than left, are improved since.
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no acute cardiopulmonary abnormality.
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persistent right-sided pleural effusion without superimposed acute cardiopulmonary process. right apical opacity better characterized by prior pet-ct
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no radiographic evidence for acute cardiopulmonary process.
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small bilateral pleural effusions. right ij catheter terminates in the right atrium. if needed to be in the distal svc, could consider retracting by <num>cm.
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support lines and tubes are unchanged in position. cardiomediastinal silhouette is within normal limits. there are no focal consolidations, pleural effusion, or pulmonary edema. there are no pneumothoraces. , md
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worse in fluid status.
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possible left lower lobe atelectasis or aspiration. a repeat pa and lateral radiograph would be helpful.
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no acute cardiopulmonary process.
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mild bibasilar atelectasis. no focal consolidation suggestive of pneumonia.
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no significant interval change when compared to the prior study.
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no acute findings in the chest.
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no acute cardiopulmonary process.
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normal chest radiograph. no pneumonia or pneumothorax.
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interval complete resolution of right lower lobe pneumonia.
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no acute cardiopulmonary process. no displaced rib fracture. no pneumothorax.
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subcutaneous defibrillator in the left anterior chest wall.
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no acute intrathoracic process.
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mildly improved right lower lobe consolidation, consistent with resolving pneumonia. mildly improved pulmonary vascular congestion.
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moderate right pleural effusion slightly larger, still collected dependently in the right lower chest. moderate enlargement of cardiac silhouette stable. no left pleural effusion. lungs grossly clear. no pulmonary edema. alignment of the sternal wires has not changed appreciably since.
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possible right lower lobe pneumonia, best visualized on the lateral radiograph. right lower lobe mass and pleural disease are grossly unchanged from ct of.
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no acute cardiopulmonary process.
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interval worsening of left lower lobe pneumonia.
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left basilar atelectasis. no acute cardiopulmonary process.
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right pigtail catheter is in place with continues decrease in the right pleural effusion with only minimal pleural fluid currently seen but still present not of the expanded right lung and currently large right pneumothorax. rest of the findings are unchanged.
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moderate pulmonary edema worsened on , subsequently improved slightly. moderate right and small left pleural effusions and left lower lobe collapse are still present. mild cardiomegaly unchanged. no pneumothorax. left subclavian infusion port ends in the upper svc, as before.
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as compared to the previous radiograph, the pre-existing pulmonary edema has improved. however, mild pulmonary edema is still present. the heart is enlarged in unchanged manner and a right pleural effusion with subsequent atelectasis is still present. unchanged position of the pacemaker leads.
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unchanged mild cardiomegaly and basilar atelectasis. no evidence of pneumonia or pneumothorax.
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no acute cardiothoracic process. mild cardiomegaly and likely calcified mediastinal/hilar lymph nodes are stable.
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normal chest.
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no evidence of metastatic disease.
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clearing of left lower lobe infiltrate or atelectasis. no new infiltrates.
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endotracheal tube terminates <num> cm above the carina and could be pulled back <num> cm. diffuse bilateral pulmonary opacities consistent with pulmonary edema. superimposed infection cannot be excluded.
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no significant change compared with earlier the same day.
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comparison to. the parenchymal opacities, notably in the right lung, have decreased in extent and severity. the moderate enlargement of the cardiac silhouette and the atelectasis in the left lung are constant. constant position of the endotracheal tube and the left central venous access line.
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no pneumonia.
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no abnormalities seen within the limitations of this study technique to explain patient's symptoms, correlation with chest ct might be considered if clinically warranted. prominence of the main pulmonary artery is noted and might potentially reflect pulmonary hypertension that also may be assessed by echocardiography or chest ct.
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proximal side hole of the nasogastric tube is at the gastroesophageal junction and could be advanced by <num> cm for more optimal positioning.
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clear lungs.
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left picc tip is in the mid svc. there are no other interval changes from prior study.
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as compared to the previous radiograph, the position of the <num> pigtail catheters on the left is unchanged. unchanged extent of a small postprocedural pneumothorax. unchanged extent of the pleural air. extensive atelectatic changes in the left lung. the appearance of the right lung and of the right heart border is constant.
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ap chest compared to through : pulmonary edema is mild, if any. opacification of the base of the left lung has been present for several days, probably atelectasis. moderate cardiomegaly is longstanding, but what is most striking is enlargement of the left pulmonary artery, which has exceeded and persisted beyond that of the right pulmonary artery. since this is sometimes a sign of pulmonary embolus that diagnosis should be considered and will be discussed with house officer caring for this patient. tip of the et tube is approximately <num> cm above the carina, <num> cm above standard position. enteric drainage tube passes into the stomach and out of view. dr was paged at , one minute following recognition of the findings, which we discussed five minutes later.
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mild interstitial edema.
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central pulmonary vascular congestion with mild pulmonary edema and small bilateral pleural effusions have slightly worsened since.
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no pneumonia.
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no acute cardiopulmonary abnormality or pulmonary edema.
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small left pneumothorax as well as pneumomediastinum and subcutaneous emphysema. a left chest tube is in place. interval placement of a right picc line extending to the superior cavoatrial junction.
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no acute findings in the chest.
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no acute cardiopulmonary process.
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since the left hilus or radiodensity projecting over the hilus has increased substantially, the adjacent border of the adjacent upper left heart border has become obscured, left hemidiaphragm has become elevated, and the upper trachea has migrated slightly to the left. these findings suggest new left upper lobe or lingular collapse, and there may be bronchial obstruction to thank. i have spoken with the referring physician to request conventional radiographs, particularly lateral and oblique views for confirmation. chest ct scanning may be necessary. right lung is grossly clear. pleural effusion is minimal if any. heart size is normal.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process.
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no acute cardiopulmonary abnormality.
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stable exam status post chest tube removal. no evidence of pneumothorax.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process.