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MIMIC-CXR-JPG/2.0.0/files/p15353817/s54639127/d35510b7-29f93984-95952c8e-f30088df-bceed5fb.jpg
there has been no interval change. the left-sided picc line has the distal lead tip at the cavoatrial junction. there is again seen diffuse airspace opacities bilaterally as well as a moderate-sized right pleural effusion. there is likely moderate pulmonary edema superimposed on the parenchymal opacities.
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no acute findings in the chest.
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in comparison to chest radiograph, a nasogastric tube has been removed. pulmonary edema has substantially decreased in extent, and a right pleural effusion has apparently resolved. no other relevant changes.
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lungs are clear. normal cardiomediastinal and hilar silhouettes. no pleural effusion. healed left rib fractures noted.
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no definite signs of pneumonia.
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mild to moderate congestive heart failure with small bilateral pleural effusions, slightly improved compared to the prior exam. bibasilar airspace opacities could reflect atelectasis, but infection or aspiration are not excluded.
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no acute cardiopulmonary process.
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heart size and mediastinum are stable. lungs are low in volume compared to the previous study but overall clear except for minimal bibasal atelectasis. there is no pulmonary edema. right central venous line has been removed. there is no pneumothorax.
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retrocardiac opacity which could be due to either atelectasis versus consolidation. two-view chest may help further characterize.
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low lung volumes with new small right pleural effusion and right base opacity representing either atelectasis or infection.
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in comparison with the study of , there again are small bilateral pleural effusions with underlying compressive atelectasis. continued enlargement of the cardiac silhouette with mild elevation in pulmonary venous pressure. central catheter remains in place.
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no acute cardiothoracic process.
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pa and lateral chest reviewed in the absence of prior chest radiographs: normal heart, lungs, hila, mediastinum and pleural surfaces. nipple should not be mistaken for lung nodules.
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bibasilar opacifications; in absence of strong concern for pneumonia, likely represent atelectasis.
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compared to chest radiographs since , most recently. new consolidation, most pronounced in the right upper lobe but also in the right lower lung is most likely pneumonia. mild cardiomegaly is more pronounced. there is no appreciable pleural effusion.
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low lung volumes with mild pulmonary edema, no lobar consolidation.
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enteric tube tip in good position. otherwise stable
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as compared to the previous radiograph, there is a massive increase in right pleural effusion. the effusion now occupies approximately half of the right hemi thorax. subsequent areas of atelectasis have developed. a hiatal hernia is visually more apparent than on the previous image. otherwise normal appearance of the left heart border and the left hemithorax.
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as compared to , the patient has developed moderate pulmonary edema. moderate cardiomegaly is seen. the tracheostomy tube and the left internal jugular vein catheter are in unchanged position. no larger pleural effusions. no pneumonia.
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no acute intrathoracic process.
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malalignment of previously aligned sternal wires, concerning for sternal dehiscence. these findings were relayed to , nurse for the cardiac surgery service, by dr telephone at on.
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no evidence of acute disease.
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no acute intrathoracic process.
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heart size is enlarged, unchanged. aorta is slightly tortuous, unchanged. right mid lung opacity, nodular appears to be new and although might represent pleural finding, pulmonary nodule is a possibility. no pleural effusion or pneumothorax is seen. assessment of the patient with chest ct is required
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interval decrease in right apical pneumothorax. extensive subcutaneous emphysema and pneumomediastinum, similar to prior exam. these findings were communicated to the patient's team at on by phone.
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new right lower lobe consolidation compatible with pneumonia. follow-up radiographs are recommended after treatment to ensure resolution.
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chronic interstitial lung disease.
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in comparison with the study of , there is little change and no evidence of acute cardiopulmonary disease. multiple healed fractures in the right chest are again noted.
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no acute intrathoracic process seen.
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subtle bibasilar opacities may be due to atelectasis but subtle aspiration or early infection not excluded.
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no definite evidence of acute disease. suspected small to moderate hiatal hernia.
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no acute cardiopulmonary process.
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new tavr in place. mild pulmonary edema is new, probably accompanied by small pleural effusions. no pneumothorax. left skin fold should not be mistaken for a pleural edge. severe cardiomegaly unchanged. et tube in standard placement. transvenous right atrial and right ventricular pacer leads are continuous from the left pectoral generator.
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possible small left pleural effusion. no pulmonary edema.
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no evidence of acute disease.
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normal chest radiographs.
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ap chest compared to : heart size top normal or slightly enlarged, pulmonary vasculature engorged, but no pulmonary edema. small left pleural effusion may have decreased since. no pneumothorax.
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no acute cardiopulmonary abnormality. no subdiaphragmatic free air identified.
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basilar atelectasis with possible mild central pulmonary vascular engorgement. no significant interval change.
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no previous images. the cardiac silhouette is within normal limits and there is no vascular congestion, pleural effusion, or acute focal pneumonia.
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slight increase in retrocardiac atelectasis with unchanged dependent and loculated right pleural effusions and atelectasis.
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increased density posteriorly seen on the lateral view thought to be technical. no definite acute cardiopulmonary process.
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no acute cardiopulmonary process.
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pa and lateral chest compared to. lung volumes are lower, small bilateral pleural effusions are new, and the only focal pulmonary abnormalities or regions of bibasilar atelectasis. lungs are otherwise clear. heart size is normal.
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hiatal hernia. no acute cardiopulmonary process.
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no pneumonia.
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unchanged bilateral pulmonary edema with associated pleural effusions. no evidence of pneumothorax.
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no acute cardiopulmonary process.
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no evidence of acute pneumonia on this portable chest examination.
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mild increase in opacity at the left lung base suggesting mild increase in pre-existing atelectasis; no definite evidence of disease.
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as compared to the previous radiograph, no relevant change is seen. elevation of the right hemidiaphragm. no pleural effusions. no pneumonia, no pulmonary edema. no pneumothorax. unchanged size of the cardiac silhouette. normal hilar and mediastinal structures.
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right internal jugular line tip is at the level of cavoatrial junction. left and right chest tubes are in place. there is interval development of distension of the stomach bubble, attention to potential aspiration is recommended. there is no pneumothorax.
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no acute intrathoracic process.
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no definite cardiopulmonary process.
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pa and lateral chest reviewed in the absence of prior chest radiographs: the lungs are well expanded and clear. contour of the right hemidiaphragm elevated due to mild eventration. no pleural abnormality or evidence of central adenopathy. heart size is normal.
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in comparison to prior radiograph from earlier the same date, small right apical pneumothorax has decreased in size. bibasilar atelectasis and small pleural effusions have worsened. no other relevant changes.
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et tube in appropriate position.
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no acute cardiopulmonary process.
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as compared to radiograph, postoperative of appearance of the cardiomediastinal contours is within normal limits in this patient status post recent coronary bypass surgery. bibasilar atelectasis is slightly improved on the right and slightly worse on the left, and small bilateral pleural effusions are also demonstrated. possible tiny left apical pneumothorax is also noted.
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severe emphysema is reflected in marked hyperinflation. increase in the small residual of consolidation at the right lung apex since raises the possibility of recurrent or new infection. clinical correlation advised. small pleural effusions if any. no evidence of cardiac decompensation. heart size normal.
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increasing right-sided pleural effusion. right lung mass, probably increased substantially, although comparison of different modalities is not entirely reliable. ct may be helpful to evaluate further if needed clinically.
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hyperinflation. no evidence of acute disease.
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in comparison with the study of , the central catheter has been removed. continued low lung volumes enhance the transverse diameter of the heart. the pulmonary vascularity is essentially within normal limits and there is no acute focal pneumonia. densely calcified left hilar lymph node is again seen.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process. no significant interval change.
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bilateral lower lobe consolidations are similar or slightly increased compared to , concerning for pneumonia. mild right upper lobe opacification is same.
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no acute cardiopulmonary process.
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compared to chest radiographs. lungs are fully expanded and clear. heart size normal. no pleural abnormality. lateral view shows fullness in the esophagus, with no definite fluid level. this could be retained fluid or esophageal thickening. recommendation(s): contrast swallow to evaluate the esophagus.
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pa and lateral chest compared to : lower lobe consolidation developed between. it has improved since and it could be atelectasis alone, given severely low lung volumes and presence of at least a small left pleural effusion. upper lungs are clear. the heart is borderline enlarged. there is no pulmonary edema.
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no acute cardiopulmonary process.
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no pneumonia.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process. compression deformity of a lower thoracic vertebral body is age indeterminate, but new from
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no acute cardiopulmonary process.
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bilateral, right greater than left, hazy opacities and left retrocardiac opacity may reflect asymmetric edema possibly with superimposed infection. et tube terminates approximately <num> cm from the carina, could withdraw <num> to <num> cm. enteric tube courses into the stomach.
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no acute cardiopulmonary process, no evidence of pneumonia.
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ap chest compared to through : since , endotracheal tube has been re-positioned, tip now at the upper margin of the clavicles, no less than <num> cm from the carina, standard placement. right lung volume remains chronically low, reflected in elevation of the hemidiaphragm and basal atelectasis. left lung is grossly clear, heart size is normal and there is no pleural abnormality. the upper enteric drainage tube ends in the upper stomach. no pneumothorax.
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no pulmonary nodules identified.
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left lower lobe consolidation has worsened. increasing opacities in the left upper lobe and left perihilar region could represent asymmetric edema or aspiration. mild pulmonary edema is otherwise stable. no other interval change from prior study.
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no evidence of acute cardiopulmonary disease.
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small reaccumulation of left pleural fluid with minimal fluid along the left major fissure. no evidence of pneumonia. evaluating changes in other significant findings on recent chest ct would require repeat chest ct.
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no acute cardiopulmonary process.
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compared to chest radiographs through ,. right basal consolidation has worsened, concerning for pneumonia. abnormal left hilus and supra hilar region are long-standing. all right pleural effusion stable. heart size normal. feeding tube with the wire stylet partially withdrawn ends in the upper stomach. tracheostomy tube in standard placement. right pic line ends in the svc, approximately <num> cm below the estimated location of the superior cavoatrial junction. no pneumothorax.
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there are no new abnormalities on the chest radiograph since. a previous left lung nodule at the level of the left eighth posterior rib is less conspicuous today. there are no new nodules, interstitial abnormality, or new consolidation. lung volumes remain low and there is thickening of the pleural surfaces particularly the right costal, but no pleural effusion. heart size is normal. mild widening of the mediastinum in the region of the right lower paratracheal station and ascending thoracic aorta is unchanged. patient has had wedge resection from the left lung apex. there is no abnormal tissue in the region.
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moderately severe pulmonary edema has worsened since. borderline cardiomegaly has increased slightly. mild engorgement of mediastinal veins suggests that primary decompensation is left ventricular. no pneumothorax.
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no acute intrathoracic process.
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left lower lobe pneumonia. findings were relayed to dr by phone at on.
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there is no longer any pulmonary edema. moderate right and small left pleural effusion are unchanged since. large cardiomediastinal silhouette has improved since it is earlier postoperative enlargement. lateral view shows that the small retrosternal air and fluid collection is still present. this is not necessarily a worrisome finding this soon after the surgery and removal of drainage tubes, approximately week ago. whether there is the possibility of mediastinal infection requires clinical assessment.
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slight improvement in mild pulmonary edema.
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cardiomegaly with mild pulmonary edema.
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as compared to the previous radiograph, the lung volumes have increased. the pre-existing effusion on the right has completely resolved. however, the left lower lobe shows an extensive parenchymal opacity that is ill-defined and shows air bronchograms. a similar but less extensive parenchymal opacity is seen in the left lower lobe. both changes are likely reflecting pneumonia. at the time of dictation and observation, the referring physician. , was notified by telephone by dr , :<num>, on the. normal size of the cardiac silhouette. minimal enlargement of the left and right pulmonary artery. minimal bilateral apical thickening, symmetrical in distribution.
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no acute cardiopulmonary abnormality.
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no acute intrathoracic process. no definite displaced rib fractures. if there is persistent clinical concern, a dedicated rib series may be performed to further assess.
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no acute intrathoracic process.
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left lower lobe collapse and/or consolidation and small left effusion is unchanged. focal opacity in the right cardiophrenic region, likely in the right lower lobe is more pronounced on the current examination. while this may represent atelectasis, in the appropriate clinical setting, the differential diagnosis could include a focal infiltrate. density at left lung apex, equivocal for tiny pneumothorax. clinical correlation is requested. if clinically indicated, a repeat frontal view of the chest, taken at end-expiration of the respiratory cycle may help for further assessment.
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streaky right basilar opacity may be due to aspiration.
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heart size is top-normal. there is overall unremarkable appearance of the mediastinum but note is made that the patient is rotated substantially. lungs are essentially clear. there is no pleural effusion or pneumothorax. there is substantial sclerosis of the left humeral head, partially imaged and to lesser extent of the right sternal head, please correlate with patient history of potential metastatic disease and dedicated radiographs are essential to those areas.
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no acute intrathoracic abnormality. minimal atelectasis versus scarring at the left lung base.
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decreased right pleural effusion. adjacent right lower lobe opacity probably reflects atelectasis but coexisting pneumonia is not excluded. small left pleural effusion.
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moderate pulmonary vascular congestion, slightly asymmetric. recommend followup after diuresis to exclude underlying infection. small bilateral pleural effusions.