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no acute cardiopulmonary process. increased soft tissue density at the upper right aspect of the mediastinum. this is unchanged compared to multiple priors but is incompletely characterized. differential considerations include right-sided thyroid enlargement, although there is no deviation of the trachea to the left, or toward tortuosity of the great vessels. underlying mass lesion or adenopathy would also be possible. additional imaging can be performed as clinically warranted.
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no acute cardiopulmonary process.
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moderate to large left pleural effusion and small right pleural effusion, with associated atelectasis. at least the left pleural effusion appears increased in size as compared to the prior study. previously seen pulmonary lesions better assessed on ct.
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no acute findings in the chest. underlying copd.
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as compared to the previous radiograph, the extensive bilateral parenchymal changes are not substantially changed. moreover, the bilateral pleural effusions are constant. moderate cardiomegaly persists. unchanged course of the right picc line.
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left lower lobe pneumonia. mild cardiomegaly.
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post-treatment changes without definite superimposed acute cardiopulmonary process.
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sternal abnormality could be normal anatomic variant or result of trauma, recent or remote. clinical examination can differentiate. please note that radiography is not sensitive for chest wall trauma.
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no acute cardiopulmonary abnormality.
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no definite acute cardiopulmonary process.
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compared to chest radiographs through. moderate pulmonary edema has improved slightly. moderate to large left pleural effusion has increased. right pleural effusion is small, unchanged. bibasilar atelectasis, left greater than right, is more severe. no pneumothorax. tip of the et tube could be as close as one cm from the carina, with the chin elevated. it should be withdrawn at least <num> cm. esophageal drainage tube passes into the stomach and out of view. left pic line ends in the mid svc.
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right internal jugular port-a-cath remains in place. interval removal of the right chest tube. no pneumothorax is seen. stable appearance to the right hemithorax with lateral pleural thickening and scattered opacities suggestive of scarring. left lung remains grossly clear. no pulmonary edema. status post median sternotomy with aortic valve replacement with stable post-operative cardiac and mediastinal contours.
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no evidence of pneumonia on portable ap single chest view examination.
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slight enlargement of the left cardiac silhouette with slight increase in right pleural effusion.
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compared to prior chest radiographs, starting , most recently. no interval change in the extensor right pleural abnormality and possible concurrent pneumonia. very low lung volumes exaggerate mild pulmonary vascular congestion and moderate cardiomegaly. no pneumothorax. extensive myelomatous change in the chest cage is long-standing.
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unchanged large right pneumothorax, right pleural effusion and left basilar opacities status post right-sided chest tube removal.
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right pleural effusion with additional basilar opacities which likely represent atelectasis. pneumonia in the correct clinical setting cannot be ruled out.
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pa and lateral chest compared to : aside from a handful of calcified granulomas, lungs are clear. cardiomediastinal and hilar silhouettes are unremarkable aside from probable right hilar lymph nodes. there are no findings to suggest active infection or malignancy. heart is normal size, and there is no pleural abnormality.
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as compared to the previous image, the patient has undergone valvular repair. the size of the cardiac silhouette is normal. normal hilar and mediastinal structures. no pleural effusions. no pneumonia, no pulmonary edema.
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status post placement of a right pigtail pleural catheter with interval decrease in the size of the right pleural effusion. persisting pulmonary edema and a left pleural effusion. no pneumothorax.
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clear lungs.
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in comparison to chest radiograph, a nasogastric tube terminates below the diaphragm with distal tip beyond the field of view. other support and monitoring devices are unchanged in position. persistent cardiomegaly and pulmonary vascular congestion. multifocal consolidations have overall improved with the exception of worsening opacification in the left retrocardiac region. no other relevant change.
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streaky opacities at the right lung base, most consistent with atelectasis, although an early infectious process cannot be excluded. clinical correlation recommended. moderate to large hiatal hernia.
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ap chest compared to : feeding tube with a wire stylet in place passes into stomach distended with gas, and out of view. moderate left pleural effusion and severe left lower lobe atelectasis, and less pronounced right pleural effusion and atelectasis, all of which developed rather suddenly on are still present. heart is borderline enlarged. there is no pulmonary edema or pneumothorax. tracheostomy tube in standard placement. left pic ends in the mid-to-low svc, as before.
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no pneumonia.
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persistent pulmonary edema, slightly improved since the most recent radiograph. left-sided picc line terminates in the right atrium. retraction by approximately <num> cm is recommended.
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bibasilar atelectasis, with interval improvement in left mid lung airspace abnormality consistent with improved aspiration pneumonitis. there is new bibasilar atelectasis and right parahilar airspace opacity.
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mild improvement in bilateral vascular congestion and right upper lobe opacity. stable retrocardiac opacity. left picc tip in upper svc.
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no acute findings in the chest. left hemidiaphragm mildly elevated.
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small region of consolidation projecting lateral to the left heart border is not localize with certainty on the lateral view, could be along the spine, but is consistent with a very small region of pneumonia. lungs are otherwise clear. cardiomediastinal and hilar silhouettes and pleural surfaces are normal.
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appropriately positioned right ij central venous catheter. no pneumothorax. emphysema and left lower lobe pneumonia unchanged.
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pa and lateral chest compared to : rll consolidation increased since , aspiration pneumonia until proved otherwise, accompanied by small right pleural effusion. mild cardiomegaly stable. no pulmonary edema. dr i discussed the findings by telephone after my page at
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patient has been extubated. central pulmonary artery enlargement is stable. moderate cardiomegaly is more pronounced, but there is no pulmonary edema or appreciable pleural effusion.
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no consolidations to suggest infection. no radiographic findings to explain dull breath sounds at the bases. multifocal metastases in the thoracic spine the above results were communicated via telephone by dr to dr , at on as requested.
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no acute cardiopulmonary process. thin linear object overlying the patient's neck on the frontal view is presumably external. correlate clinically.
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ap and lateral chest on compared to : overall, hyperinflation suggests emphysema. the bronchiectasis and mild peribronchial opacification in the right upper lobe may well be residua of severe necrotizing pneumonia that the patient had in. lower lungs are clear. very small right pleural effusion is probably not clinically significant. heart size top normal. no pulmonary edema. bulbous quality to the left hilus is difficult to assess because of patient rotation.
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in comparison with the study of , there is little interval change. low lung volumes with elevation of the right hemidiaphragmatic contour is again seen. mild enlargement of the cardiac silhouette is again noted, but no evidence of vascular congestion or acute focal pneumonia.
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et tube is in standard position. ng tube tip is in the stomach. cardiac size is top-normal. mild vascular congestion and bibasilar atelectasis larger on the left side are new. there is no pneumothorax or large effusions
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persistent enlargement of the cardiac silhouette. trace blunting of the right costophrenic angle suggests a trace pleural effusion.
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no acute cardiopulmonary process.
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streaky left lower lobe opacities, which could be due to mucoid impaction or peribronchial infiltration related to an infection. standard pa and lateral chest radiographs may be helpful for more complete evaluation of this region when the patient's condition permits.
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no acute cardiopulmonary process.
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large right hydro pneumothorax has continued to fill with fluid, now almost entirely replacing air. right lung is essentially collapsed. heterogeneous opacification in the left lung has generally improved others residual opacity at the left lower lobe which could be pneumonia. no left pleural effusion or pneumothorax. mediastinum is shifted slightly to the left, reflecting the long chronicity and slow progression right supraclavicular central venous infusion port ends in the region of the superior cavoatrial junction, as of the right hydro pneumothorax.
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comparison to. the patient has developed a mild to moderate right pleural effusion and a minimal left pleural effusion, better appreciated on the lateral than on the frontal radiograph. overinflation persists. mild pulmonary edema is present. stable mild cardiomegaly.
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limited view suggesting pulmonary edema. if a more complete evaluation for the possibility of pneumonia is needed, then additional radiographs could be performed, preferably with standard pa and lateral technique if possible clinically.
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left chest tube in place with a left inferior pneumothorax. persistent left lower lobe opacity, likely infectious versus hemorrhage.
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decreased right pleural effusion following revision of right thoracostomy tubes. persistent basal pneumothorax may reflect pleural restriction. severe cardiomegaly is chronic.
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with study of , there is little overall change. again there is substantial enlargement of the cardiac silhouette with essentially normal pulmonary vasculature. this discordance suggests cardiomyopathy or possibly even pericardial effusion. no evidence of acute focal pneumonia.
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cardiomegaly. no evidence of pulmonary edema or pneumonia.
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elevated right hemidiaphragm. no definite acute displaced fracture identified, although if clinical concern is high, ct is more sensitive.
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as compared to , no relevant change is seen. no evidence of pneumonia. moderate cardiomegaly. no pulmonary edema, no pleural effusions.
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comparison to. the pre-existing mild to moderate pulmonary edema has completely resolved. currently there is no evidence of over hydration or pulmonary edema. borderline size of the heart persists. no pleural effusions. no pneumonia.
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no evidence of acute cardiopulmonary process.
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mild interstitial abnormality which could be seen with mild vascular congestion versus chronic change. these are difficult to distinguish since prior radiographs are not available. nodular density projecting over the right lower lung suggesting a nipple shadow. when clinically appropriate, however, confirmation of a nipple shadow as opposed to a pulmonary nodule is suggested by acquiring an additional pa view with nipple markers.
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cardiomegaly with a moderate right pleural effusion.
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no acute cardiopulmonary process.
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low lung volumes with bibasilar atelectasis. mild prominence of the pulmonary vasculature with no overt pulmonary edema.
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comparison to. the endotracheal tube was removed and has been replaced by a tracheostomy tube. the tracheostomy tube is in correct position. the feeding tube was removed. the left and right central venous access lines are in stable position. low lung volumes persist. slight increase in extent of pre-existing right lateral pleural thickening. no pneumothorax.
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no acute cardiopulmonary abnormality.
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in comparison with the study of , there has been placement of a dobbhoff catheter that extends to the distal stomach. the cardiac silhouette remains within normal limits and there is no evidence of vascular congestion or pleural effusion. no acute focal pneumonia. possible streak of atelectasis at the left base.
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mild pulmonary vascular congestion and bibasilar atelectasis. compression deformity of a vertebral body at the thoracolumbar junction is new compared to.
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ap chest at compared to. substantial left lower lobe collapse persists and the small to moderate left pleural effusion is larger. no pneumothorax. left upper lung and right lung clear. heart size is normal. mediastinal and hilar silhouettes are not remarkable aside from leftward mediastinal shift which is unchanged.
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no acute cardiopulmonary process. diffuse bronchial wall thickening probably reflects chronic airways inflammation.
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no acute cardiopulmonary process. stable moderate cardiomegaly.
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comparison to. moderate cardiomegaly. mild to moderate pulmonary edema. no relevant change as compared to the previous image. no evidence of pneumonia. monitoring and support devices continue to be correctly position.
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no acute cardiopulmonary abnormality.
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right lower lobe opacity concerning for pneumonia or aspiration. mild pulmonary vascular congestion.
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ett in satisfactory position. stable chest radiograph compared to prior.
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single lead icd terminating at the cardiac apex. no pneumothorax.
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no acute intrathoracic process.
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decrease opacification of left hemithorax, which may reflect improving pleural effusion or may be due to semi-erect positioning. lateral view would be helpful for further evaluation.
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mild interstitial edema, new from prior.
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no evidence of intra-abdominal free air. stable cardiomegaly. no evidence of decompensated congestive heart failure or pneumonia.
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no relevant change as compared to the previous image. the lung volumes have increased. no pneumothorax of the right upper lobe wedge resection. borderline size of the heart. mild elongation of the descending aorta. no pneumonia, no pulmonary edema, no pleural effusions. a small platelike atelectasis is seen on the lateral image only.
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there is no residual pneumothorax. there is stable perihilar density on the right.
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support lines and tubes are unchanged in position. heart size is upper limits of normal. there has been worsening of the bilateral effusions and pulmonary edema. there is also a left retrocardiac opacity. there are no pneumothoraces.
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no acute cardiopulmonary process.
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pa and lateral chest compared to through. emphysema is severe. the volume of lung affected by pneumonia in the right middle and lower lobes has improved, but the severity of consolidation has worsened and there is a new small right pleural effusion. careful followup advised to monitor what could be developing purulent fluid collection. smaller region of pneumonia in the left lower lobe is improved slightly. heart size is normal. there is no pulmonary edema.
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pa and lateral chest reviewed in the absence of prior chest imaging: lungs are fully expanded and clear. cardiomediastinal and hilar silhouettes and pleural surfaces are normal. it should be noted that this study does not constitute a thorough evaluation of the airway, which could be a source of hemoptysis.
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likely left basilar atelectasis. no definite acute cardiopulmonary process.
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no acute cardiopulmonary process.
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no evidence of pneumonia.
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heart size is normal. mediastinum is normal. lungs are clear. there is no pleural effusion or pneumothorax.
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right base opacity may be due to consolidation from infection or aspiration. slight blunting of the posterior left costophrenic angle most likely due to pleural thickening rather than trace pleural effusion. prominence of the main pulmonary arteries suggests component of pulmonary arterial hypertension. slightly prominent ap window could be due to prominent pulmonary artery, however, underlying lymphadenopathy is not excluded. consider follow-up nonurgent chest ct for further assessment.
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no acute chest pathology.
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no acute findings.
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chronic persistent large right pleural effusion is increasing since following removal of the right pigtail drainage catheter. right lung is largely atelectatic. edema in the left lung is only mild in the periphery of the lung. centrally there is considerable consolidation, which has not improved. heart size is normal. small to moderate left pleural effusion is stable. there is no pneumothorax. right jugular line ends in the low svc near the superior cavoatrial junction. et tube is in standard placement. feeding tube ends in the upper stomach. esophageal drainage tube ends at the gastroesophageal junction would need to be advanced at least <num> cm to move all side ports below the diaphragm. bowel in the left upper abdominal quadrant is at least moderately distended.
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as compared to the previous examination, the parenchymal opacity at the right lung base, better seen on the lateral than on the frontal image, has only minimally decreased in extent and severity. no opacities have newly appeared. no pleural effusions. no pulmonary edema. unchanged size of the cardiac silhouette.
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no comparison. the lung volumes are low. borderline size of the heart. mild elongation of the descending aorta. no pleural effusions. no pneumonia, no pulmonary edema. dorsal areas of atelectasis, documented on on outside hospital ct examination from are not visualized on the radiograph.
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no acute cardiopulmonary process.
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interval placement of right-sided pigtail catheter. no gross effusion. no pneumothorax detected. bilateral opacities are non-specific, but compatible with atelectasis.
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relatively low lung volumes. medial right base opacity could be due to atelectasis, consolidation is not excluded in the appropriate clinical setting.
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single lead icd terminating at the cardiac apex. no pneumothorax.
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no focal consolidation. stable findings of pulmonary hypertension and copd.
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mild interstitial edema. patchy lower lung opacity seen on the lateral view could be due to infectious process. recommend followup to resolution.
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no acute cardiopulmonary process. specifically, no evidence of pneumonia.
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no relevant change as compared to the previous image. no pneumonia, no pulmonary edema. no pleural effusions. borderline size of the cardiac silhouette. normal hilar and mediastinal contours.
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bibasilar opacities which may be due to atelectasis, aspiration, infection not excluded.
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bibasilar atelectasis and bilateral effusions. improved, but residual, left lower lobe collapse/consolidation compared with. the right effusion could be very slightly larger. no chf.
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slight interval increase in size of the right pleural effusion.