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MIMIC-CXR-JPG/2.0.0/files/p15577009/s53655591/94c3849a-c644a459-8dc12d5d-90d13019-4e38db40.jpg
increased small hazy opacities in the right lung, especially right upper , concerning for an infectious process.
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no evidence of acute cardiopulmonary process.
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low lung volumes without acute cardiopulmonary process. if symptoms persist, consider repeat radiograph with improved inspiratory level to more fully evaluate the lung bases.
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small region of consolidation in the right lower lobe compatible with pneumonia given patient's history.
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persistent severe pulmonary edema. stable moderate left pleural effusion and left lower lobe volume loss.
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esophageal drainage tube passes into the nondistended stomach and out of view. since the patient is rotated to his left it is hard to say whether there is any mediastinal shift in that direction opacification of the left lower lobe is long-standing and suggests atelectasis as well. mild edema and vascular congestion in the right lung earlier today has nearly cleared. left jugular line ends close to the superior cavoatrial junction.
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no acute intrathoracic process, specifically no signs of pneumonia.
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possible very minimal pulmonary vascular congestion. otherwise, no acute cardiopulmonary process.
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small bilateral pleural effusions and bibasilar atelectasis. status post esophagectomy and gastric pull-through. tracheostomy tube in unchanged position.
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marked interval worsening of biapical opacities could be due to atelectasis or aspiration. marked increase in left lower lobe retrocardiac opacity is a combination of effusion and atelectasis. mild vascular congestion is new. small right effusion has increased. et tube is in standard position. left basal chest tube is in standard position. left subcutaneous emphysema is minimal. multiple rib and scapular fractures are better seen on prior ct
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no acute cardiopulmonary abnormality.
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no acute cardiopulmonary abnormality.
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successfully resolved chf. no new abnormalities.
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pa and lateral chest compared to : widespread opacification in both lungs has been present to some degree since at least. the asymmetry suggested concurrence of pulmonary edema and multifocal pneumonia. right lung has slowly continued to clear, the appearance of the left, which was never as severely involved as the right, has been relatively constant, but since , it too has shown better aeration. the major change over the past two days has been an increase in the volume of moderate right pleural effusion. this could have been the result of since resolved cardiac decompensation, which was responsible for transitory worsening, particularly of the left lung on. moderate cardiomegaly persists. mediastinal venous engorgement has improved. right jugular line ends in the upper right atrium. no pneumothorax.
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no acute cardiopulmonary process.
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no acute intrathoracic process.
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no acute cardiopulmonary abnormality.
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no acute cardiopulmonary process.
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no radiographic evidence of pneumonia.
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ap chest compared to at : small left pleural effusion has decreased since earlier in the day. no pneumothorax. in the interim, the mediastinal, hilar, and pulmonary vasculature have become engorged and a small right pleural effusion has developed, and heart size is now top normal.
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low lung volumes. left basilar atelectasis. possible right-sided thyroid nodule or goiter resulting in leftward tracheal deviation. clinical correlation is recommended and consider nonemergent thyroid ultrasound for further assessment if not done previously.
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cardiomegaly and mediastinal position are similar. left upper lobe scar like tissue is similar to previous examination and can be seen with minimal changes dating back to. bilateral pleural effusions are unchanged since , moderate. slight interval improvement in pulmonary edema is demonstrated more nodular opacity a adjacent to the scarring changes in the left upper lung can be seen on several prior studies but appears to be no more dense and does potential progression in this area is recommended. does assessment with chest ct would be justified.
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previously idenfitifed small left pneumothorax is not seen on this radiograph. multiple left-sided rib fractures.
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no acute cardiopulmonary process.
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lingular pneumonia. recommend followup to resolution.
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no acute pulmonary process, stable mild cardiomegaly.
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limited exam. patchy right basilar opacity may reflect atelectasis or infection. no displaced rib fractures seen, but assessment of the right-sided ribs is limited on this study. please note that a dedicated rib series can be obtained for further assessment.
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no evidence of acute cardiopulmonary process. chronic likely posttraumatic changes centered at the left acromioclavicular joint.
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no acute intrathoracic process.
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retrocardiac linear opacities are likely atelectasis but could represent infection in the appropriate clinical setting.
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no acute cardiopulmonary pathology.
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new right lung consolidation and right pleural effusion; pleural metastasis cannot be excluded. further evaluation is recommended with chest ct with iv contrast if clinically possible. findings and recommendations were discussed with by by telephone at on at the time of discovery of these findings.
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no acute cardiopulmonary process.
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no significant interval change when compared to the prior study.
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no evidence of acute cardiopulmonary abnormalities or intrathoracic metastatic disease.
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no acute cardiopulmonary abnormality.
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heart size and mediastinum are stable in appearance including replaced mitral valve. apical pneumothorax is bilateral, small and unchanged. bibasal atelectasis and small amount of bilateral pleural effusion is unchanged.
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improving pulmonary edema.
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no evidence of acute cardiopulmonary process.
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no acute cardiopulmonary process.
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as compared to the previous radiograph, no relevant change is seen. the monitoring and support devices are constant. normal size of the cardiac silhouette. normal hilar and mediastinal structures. no pneumonia, no pulmonary edema.
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possible left fifth rib fracture. correlation with point tenderness is recommended. please note that plain chest radiograph is inadequate to assess for traumatic injuries of the chest. if there is persistent concern, dedicated films of the ribs can be obtained for better evaluation. possible aneurysmal dilatation of the descending aorta.
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large left-sided pneumothorax with slight increase in size over the interval and rightward shift of the mediastinum, consistent with tension pneumothorax.
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heart size normal. mild bibasilar atelectasis are unchanged. no pulmonary edema pneumonia. no pneumothorax or appreciable pleural effusion. et tube and right internal jugular line in standard placements. nasogastric tube ends in the upper part of a nondistended stomach.
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no acute cardiopulmonary process.
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as compared to the previous radiograph, no relevant change is seen. moderate cardiomegaly. mild tortuosity of the thoracic aorta. mild overinflation. no pneumonia, no pulmonary edema. no pleural effusions.
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no acute findings including no sign of pneumoperitoneum.
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volume overload, however concurrent multifocal pneumonia cannot be excluded.
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no acute cardiopulmonary process.
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no acute cardiopulmonary abnormality
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mild interstitial edema.
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no acute cardiopulmonary process.
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as compared to the previous radiograph, both the right picc line and the dobbhoff catheter have been removed. the lung volumes are relatively low but there is no evidence of atelectasis at the lung bases. no pleural effusions. no pneumonia. unchanged mild cardiomegaly. unchanged appearance of healed left-sided rib fractures.
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no recurrent pneumothorax. small right pleural effusion.
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basilar atelectasis without convincing signs of pneumonia. interval removal of picc line.
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no acute cardiopulmonary process.
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doubt significant interval change. suspect distorted parenchymal markings, suggestive of possible bullous change. alternatively, this could represent residua from the prior pneumothorax.
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comparison to. new diffuse interstitial markings, with lower lobe predominance, and predominantly in peribronchial location. in the appropriate clinical setting, the findings are likely suggesting mild interstitial pulmonary edema, notably given that the cardiac silhouette has also increased in size. unchanged elongation of the descending aorta. correct alignment of the sternal wires. no pleural effusions.
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left retrocardiac opacity might represent pneumonia given context. atelectasis considered given volume loss.
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as compared to the previous radiograph, no relevant change is seen. the lung volumes are normal. normal size of the cardiac silhouette. normal hilar and mediastinal contours. mild scoliosis. no pneumonia, no pleural effusions, no pulmonary edema. the bony structures of the chest wall appear unremarkable. there is no radiographic abnormality of the right clavicle.
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right middle lobe and left lower lobe pneumonia with tiny bilateral pleural effusions. emphysema again noted.
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no significant interval change since recent exam. cardiomegaly and mild pulmonary vascular congestion with small effusions.
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normal chest x-ray.
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since previous intra-aortic pump balloon has been removed. mild pulmonary edema has improved, but substantial right pleural effusion and left lower lobe collapse remain and moderate to severe cardiomegaly is stable. no pneumothorax. et tube and right jugular line are in standard placements and an esophageal drainage tube passes into the stomach and out of view.
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no acute cardiopulmonary abnormality.
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in comparison with the earlier study of this day, there is little overall change. monitoring and support devices remain in good position. bibasilar opacifications are again seen in the upper lung zones are clear without evidence of pulmonary vascular congestion.
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no evidence of pneumonia. multifocal lymphadenopathy, consistent with history of cll, with apparent decrease in extent since recent radiograph.
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no acute cardiopulmonary abnormality.
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no evidence of acute cardiopulmonary abnormalities.
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there is mildly increased thickening along the right lateral pleura concerning for residual empyema. small to moderate right pleural effusion and associated atelectasis are unchanged.
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slight and since the prior examination. advancement of the endotracheal tube could be considered.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process. no radiopaque foreign body is visualized.
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no acute cardiopulmonary process.
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no evidence of acute cardiopulmonary abnormalities.
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limited, negative.
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support lines and tubes are unchanged in position. heart size is upper limits of normal but stable. there are low lung volumes with crowding of the pulmonary vascular markings at the lung bases. there is improved aeration at the left base; however, there remains atelectasis. a small pleural effusion on the right side may be present.
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low lung volumes which accentuate the bronchovascular markings, but no definite focal consolidation seen.
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as compared to the previous radiograph, all monitoring and support devices have been removed. the lung volumes have minimally decreased. there is evidence of minimal fluid overload but no overt pulmonary edema is present. no pneumothorax. no larger pleural effusions. minimal atelectasis at the left lung bases. moderate cardiomegaly with enlargement of the left ventricle.
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compared to chest radiographs. severe bibasilar atelectasis worsened since. upper lungs clear. no appreciable pleural effusion. heart size normal. no pneumothorax.
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comparison to. mild improvement with mild decrease in extent of the left pleural effusion. the right pleural effusion has not substantially changed. no substantial change in appearance of the cardiac silhouette. stable correct position of the feeding tube and the right picc line.
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no acute cardiopulmonary process.
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in comparison with the study of , there is scatter radiation related to the size of the patient that somewhat obscures detail. allowing for the ap portable projection instead of the previous pa the upright examination, there probably is little overall change in the appearance of the cardiac silhouette with no definite vascular congestion, pleural effusion, or acute focal pneumonia.
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as compared to the previous image, the endotracheal tube is still located to low, with the new <num> cm of the carinal, and should be slightly pulled back. the patient has received a right internal jugular vein catheter, the course of the catheter is unremarkable, the tip of the catheter projects over the mid svc. the patient has also received the nasogastric tube, the course of the tube is normal, the tip of the tube is not directly visualized on the image. there is unchanged evidence of very low lung volumes and mild to moderate pulmonary edema as well as of a likely mild left pleural effusion with a small retrocardiac atelectasis. a platelike atelectasis is also seen paralleling the right upper aspect of the mediastinum. no pneumothorax.
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no evidence of pneumonia. resolution of pulmonary edema. stable moderate cardiomegaly.
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right basilar pneumonia. mild pulmonary edema. mild cardiomegaly is stable.
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no acute cardiopulmonary process.
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previous mild pulmonary edema has resolved and small pleural effusions have decreased. moderate to severe cardiomegaly is stable but pulmonary vascular engorgement in the mediastinum has improved. et tube in standard placement. right jugular line ends at the origin of the svc. esophageal drainage tube passes into the stomach and out of view.
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no acute intrathoracic process.
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as compared to radiograph, cardiomediastinal contours are stable. lungs are clear, with no new areas of consolidation to suggest the presence of pneumonia.
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a aeration in both lungs has improved. this probably been an interval decrease in moderate bilateral pleural effusion and improvement in left lower lobe atelectasis. mild cardiomegaly has decreased. no pneumothorax. et tube in standard placement. left pic line ends in the upper svc and a right central venous line ends in the right atrium.
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in comparison to study obtained five hours prior, there is no significant change in right paramediastinal fluid collection which may represent loculated hydropneumothorax.
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there are no prior chest radiographs available for review. lungs are fully expanded and clear. cardiomediastinal and hilar silhouettes and pleural surfaces are normal.
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no new focal consolidations concerning for pneumonia.
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no acute cardiac or pulmonary process. unchanged mild cardiomegaly. deviation of the trachea to the right at the level of the thoracic inlet may be due to a left-sided thyroid nodule. correlation with physical exam is recommended. impression point #<num> was emailed to the ed qa nurse at on.
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endotracheal tube is <num> cm above the carina and should not be advanced any further. unchanged right upper lobe paramediastinal opacity compatible with infectious process or aspiration as seen on the previous ct.
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no acute cardiopulmonary process.
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no evidence of hilar lymphadenopathy.
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dobhoff tube terminates in the stomach. worsening bibasilar opacities, particularly on the left, and aspiration or pneumonia should be considered in the appropriate clinical setting.
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in comparison with the study of , there is decreased opacification at the right base in this patient with the previous vats decortication. no evidence of pneumothorax. residual postoperative changes are seen at the right base with decreasing atelectasis and pleural thickening. no evidence of acute pneumonia.