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MIMIC-CXR-JPG/2.0.0/files/p18189739/s57572524/73999769-d3581ec9-89ece2c6-7d406e2f-f33c8176.jpg
mild pulmonary edema, slightly improved in the interval, with continued small bilateral pleural effusions and bibasilar atelectasis.
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no acute intrathoracic process.
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with the earlier study of this date, there is little overall change. low lung volumes accentuate the prominence of the cardiac silhouette. some mild indistinctness of pulmonary vessels suggests some elevated pulmonary venous pressure. there is blunting of the costophrenic angles which could reflect small bilateral pleural effusions.
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similar appearance of two focal ill-defined opacities within the right upper lobe better characterized on recent chest ct dated as well as. no new focal opacity identified.
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in comparison with the study of , there is increasing opacification at the left base, consistent with worsening pleural effusion and volume loss in the left lower lobe. the generalized opacification obscures the region of the lung abscess. opacification just above the effusion could represent site of infection.
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moderately enlarged heart size, stable since. no findings concerning for pulmonary edema or pneumonia.
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significant interval worsening of left sided pleural effusion with concurrent moderate to severe atelectasis. no focal parenchymal opacities in the aerated lungs to suggest pneumonia. interval improvement of small right-sided pleural effusion.
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no acute findings in the chest.
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no acute intrathoracic process.
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low lung volumes without acute cardiopulmonary process.
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probable pneumonia. hiatus hernia. new mild cardiomegaly and increased small pleural effusions. no pulmonary edema.
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as compared to the previous radiograph, the extensive bilateral parenchymal opacities, diffusely distributed in both lungs, are not substantially changed. the lung volumes remain low. moderate cardiomegaly. no pleural effusions.
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complete resolution of previously seen pneumonia.
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pa and lateral chest compared to : heart size borderline enlarged. lungs clear. no pneumonia or pulmonary edema. no pleural effusion.
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no acute cardiopulmonary process.
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no pulmonary mass detected within the limits of a radiographic examination.
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minimal retrocardiac atelectasis in the setting of low lung volumes. no focal consolidation to indicate pneumonia.
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no acute cardiopulmonary process.
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indwelling transvenous right atrial right ventricular pacer defibrillator leads continuous from the left pectoral generator. regions of ground-glass opacity at the lung periphery, right greater than left could be edema or viral pneumonia. heart size is normal. pleural effusion small if any. no pneumothorax.
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new airspace opacity in the right mid lung zone may reflect pneumonia in the proper clinical context.
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as compared to the previous radiograph, the postoperative left lung is better expanded but a moderate air collection in the left hemi thorax persists. moderate atelectasis at the left and the right lung bases. air inclusions in the left chest wall are constant. moderate cardiomegaly without pulmonary edema. the left chest tube is in unchanged normal position.
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subtle patchy left lower lobe opacity raising concern pneumonia in appropriate clinical setting.
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unremarkable examination of the chest.
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slightly decreased pulmonary edema compared to most recent study, however right upper and lower lobe parenchymal opacities are more prominent and may represent pneumonia. lines and tubes are in standard position.
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low lung volumes with bibasilar and left retrocardiac atelectasis.
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endotracheal tube terminates approximately <num> cm above the level of the carina. nasogastric tube courses below the level of the diaphragm, inferior aspect not included on the image. left base opacity may represent a combination of pleural effusion or atelectasis, underlying consolidation not excluded. pulmonary edema, increased since prior study.
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no acute cardiopulmonary process. mild cardiomegaly.
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as compared to the previous radiograph, the left chest tube is in unchanged position. hilar atelectasis in the retrocardiac lung regions and at the right lung base. no pneumothorax. mild overinflation of the stomach. borderline size of the cardiac silhouette.
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no acute cardiopulmonary abnormality.
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bibasilar atelectasis without focal consolidation.
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no acute cardiopulmonary process.
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no evidence for acute cardiopulmonary process.
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compared to chest radiographs since , most recently. a large volume of subcutaneous air has increased substantially in the right breast and chest wall suggesting a pleuroparenchymal cutaneous connection, most likely are around the insertion sites of the <num> right apical thoracostomy tubes. right apical pneumothorax is small, and there is only a small volume of any of right pleural effusion if any. atelectasis in the right lower lung is mild. left lung is clear. heart size is normal. extent of rightward mediastinal shift is mild and unchanged. et tube in standard placement. right jugular line ends in the low svc. nasogastric drainage tube passes into the stomach and out of view.
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small right pleural effusion, unchanged compared to prior study. small right apical pneumothorax, unchanged compared to prior study. right lower lung opacity, unchanged compared to multiple priors, likely represents atelectasis, however a superimposed pneumonia cannot be excluded in the appropriate clinical setting.
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decreased size and density of the previously described mass and nodule.
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in comparison with the study of , the nasogastric tube is been removed. the dobhoff tube just straddles the esophagogastric junction and should be pushed forward about <num> cm for more optimal positioning. there is increasing opacification at the right base. this is consistent with worsening pleural effusion and compressive atelectasis. less prominent basilar opacification is noted on the left. the cardiac silhouette remains enlarged and there may be some mild elevation of pulmonary venous pressure. a more coalescent area of opacification is again seen in the right mid zone. in the appropriate clinical setting, this could reflect superimposed pneumonia.
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no fracture evident. stable mild interstitial edema with right-sided pleural pleural fluid layering along the fissural planes, unchanged compared to prior study.
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interval decrease in size of the loculated right pleural effusion, which now is small. tiny left pleural effusion. no evidence of pneumonia.
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bilateral pleural effusions. enlargement of the cardiac silhouette with a configuration raising concern for underlying pericardial effusion.
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normal chest findings, no evidence of acute pneumonic infiltrate in patient with cough and sputum production.
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feeding tube terminates in the region of the duodenal-jejunal junction. nasogastric tube terminates within the stomach with associated decrease in gastric distension compared to chest radiograph. no other relevant change.
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mild pulmonary edema, improved since. no confluent consolidation.
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lungs clear. heart size normal. normal mediastinal and hilar silhouettes and pleural surfaces.
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bilateral pleural effusions, left greater than right, as on prior. no visualized rib fracture on these nondedicated views.
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no pneumonia, edema, or effusion.
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postoperative changes status post right thoracoplasty with a small amount of subcutaneous emphysema and small to moderate right pleural effusion but no large pneumothorax.
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stable copd and chronic bronchiectasis. no evidence to suggest an acute cardiopulmonary process.
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no acute intrathoracic process.
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status post pacemaker insertion. no pneumothorax, mild pulmonary edema, small bilateral pleural effusions.
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comparison to. the pre-existing right pneumothorax has resolved. the right lung is completely expanded. no evidence of tension. normal appearance of the heart and of the left lung.
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compared to chest radiograph,. borderline cardiomegaly unchanged. pulmonary and mediastinal vasculature are normal. lungs clear. no pleural abnormality. hiatus hernia noted.
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status post median sternotomy with stable cardiac and mediastinal contours. interval removal of the right internal jugular introducer catheter. lung volumes have improved but there is still residual patchy opacity at the right lung base which most likely represents patchy atelectasis, although pneumonia cannot be entirely excluded. no evidence of pulmonary edema. no large effusions. no evidence of pneumothorax.
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low lung volumes. moderate interstitial edema.
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dobhoff tube tip isout of view, below the diaphragm. no other interval change from prior study.
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compared to chest radiographs since , most recently. lungs are fully expanded and clear. cardiomediastinal and hilar silhouettes and pleural surfaces are normal.
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comparison to , the endotracheal tube was removed and has been replaced by a tracheostomy tube. no complications, notably no pneumothorax. atelectasis at the right lung bases. moderate cardiomegaly persists. the monitoring and support devices are otherwise constant.
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left upper lobe pneumonia as well as unchanged bibasilar atelectasis/scarring.
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stable appearance of the chest with mild cardiomegaly and hilar engorgement with mild interstitial pulmonary edema.
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compared to chest radiographs since , most recently through. severe bilateral pulmonary consolidation unchanged. bronchial stents, bronchus intermedius and left main bronchus intact, have not migrated. left cardiac border is partially obscured, mild cardiomegaly is probably unchanged. mild concurrent pulmonary edema would be difficult to exclude. pleural effusions are small if any. no pneumothorax. tip of the endotracheal tube is above the upper margin of the clavicles, no less than <num> cm from the carina and could be advanced <num> cm for more secure positioning. left internal jugular line ends in the low svc. right apical and left basal thoracostomy tubes unchanged in their respective positions.
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mild interval decrease in size of the right-sided pneumothorax.
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mild bibasilar atelectasis. otherwise, no significant interval change. no acute cardiopulmonary process.
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new left basilar opacification, possibly representing atelectasis, though infection cannot be excluded, with new small to moderate sized left pleural effusion.
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no evidence of acute cardiopulmonary disease. left-sided picc line terminating in the left brachiocephalic vein.
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there are no abnormalities conforming to the cluster of irregular opacity seen on the previous study except for minimal bronchial wall thickening in the anterior segment of the right upper lobe. unless there was a pulmonary abnormality that has cleared in less than <num> days, the questioned lung lesions are probably calcifications in the right fourth anterior rib cartilage.
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slightly increased in bilateral lower lobe atelectasis. no pulmonary edema or pneumonia.
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no radiographic evidence of pneumonia.
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no acute chest abnormality.
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as compared to the previous radiograph, no relevant change is noted. borderline size of the cardiac silhouette. elongation of the descending aorta. right pectoral port-a-cath. no pneumonia, no pulmonary edema. no pleural effusions.
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endotracheal tube is in standard position, but nasogastric tube side port is proximal to ge junction with distal tip terminating in the proximal stomach. heart size is normal. right lower lobe is collapsed. partial atelectasis of right upper lobe is also demonstrated. possible small right pleural effusion. there is no pneumothorax.
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persistent right lower lobe opacity, concerning for aspiration or pneumonia.
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top-normal to mildly enlarged cardiac silhouette. no pulmonary edema. no focal consolidation.
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comparison. no relevant change. monitoring and support devices are in stable position. stable alignment of the sternal wires. borderline size of the cardiac silhouette. no pulmonary edema, no pleural effusions. no pneumonia.
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no evidence of pneumonia.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process.
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in comparison to chest radiograph, a subtle area of opacity has developed in the left retrocardiac region, partially obscuring the descending thoracic aortic interface. this may reflect focal atelectasis, aspiration, or early infectious pneumonia. no other relevant change.
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mild pulmonary edema.
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moderate left pleural effusion with some loculated components seen superiorly. left suprahilar mass concerning for malignancy
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ng tube with the tip in the stomach. no acute cardiopulmonary process.
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heart is mildly to moderately enlarged but pulmonary vasculature is unremarkable and there is no edema or pleural effusion. lungs are clear aside from a band of atelectasis in the left midlung.
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no acute cardiopulmonary abnormality.
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normal chest radiograph.
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no acute cardiopulmonary process. no definite rib fracture or pneumothorax.
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moderate cardiomegaly is unchanged. interval improvement in pulmonary edema is substantial with residual most prominently seen in the right mid and lower lung. there is no appreciable pleural effusion. superimposed infectious process is better appreciated on the chest ct obtained on at
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small to moderate left pleural effusion is mildly decreased. pulmonary edema is mild.
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mild to moderate cardiomegaly new since without evidence of vascular congestion or interstitial edema.
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pa and lateral chest compared to. on two frontal views of the chest, the upper portion of the right heart border is partially obscured. on , this was clear, and is therefore concerning for pneumonia even though the findings on the lateral view are somewhat equivocal. if this is not pneumonia, it is due to chronic atelectasis or recurrent pneumonia in the right middle lobe since the right heart border was also obscured on. i would recommend ct scanning to evaluate the bronchial airways. lungs are otherwise clear. mild cardiomegaly is unchanged. there is no pleural effusion. if the patient declines ct scanning, i would repeat chest radiograph in no more than four weeks in hopes of documenting clearing of the right middle lobe. dr was paged at as soon as the findings were recognized and we discussed the findings by telephone <num> minutes later.
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no pulmonary edema.
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no evidence of acute cardiopulmonary disease.
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as compared to prior radiograph of <num> days earlier, nasogastric tube is been placed, with tip terminating in the upper stomach, and side port likely in close proximity to the ge junction. exam is otherwise unchanged.
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as compared to the previous radiograph, no relevant change is seen. normal size of the cardiac silhouette. normal hilar and mediastinal structures. no pleural effusions. no pneumonia, no pulmonary edema.
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no acute intrathoracic abnormality.
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right-sided port-a-cath terminates in the mid svc, unchanged from the prior radiograph.
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interval intubation with the tip of the endotracheal tube <num> cm above the carina. improved aeration of both lungs, particularly on the left side. there is diffuse airspace process in the right lung as well as more patchy focal process at the left lung base. these findings could reflect asymmetric pulmonary edema, although bilateral pneumonia should also be considered. overall, cardiac and mediastinal contours are stable. previously reported more focal nodular opacity in the right upper lobe again is not well appreciated on the current study due to the diffuse airspace process. spinal fusion hardware overlying the lower cervical spine is incompletely visualized.
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left pic line is undisturbed since , probably ending at the origin of the svc, distorted by scoliosis and leftward rotation of the patient. mild interstitial edema and borderline cardiomegaly are unchanged. there is no focal pulmonary abnormality or pleural effusion. no pneumothorax.
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pa and lateral chest compared to through : small region of consolidation at the medial aspect of both lung bases has been present to varying degrees since. the left is more persistent and therefore more likely atelectasis. on the right, there may be a region of consolidation that was not present on. small bilateral pleural effusions are decreasing. upper lungs are clear and the heart is normal size. tracheostomy tube above the left wall of the trachea. no evidence of central adenopathy. no pneumothorax.
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the right subclavian picc line is seen with its tip in the mid svc. a nasogastric tube is seen coursing below the diaphragm with the tip not identified. the pulmonary edema appears to be improving. overall, cardiac size is stable. the left upper lung is not included on the current examination. results of the picc position were communicated by phone to , the iv nurse on at
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ap chest compared to : mild pulmonary edema and pulmonary and mediastinal vascular engorgement, and mild cardiomegaly have all worsened. there is more consolidation at both lung bases, whether this is atelectasis or pneumonia is radiographically indeterminate. small bilateral pleural effusions reflect cardiac decompensation. there is no pneumothorax. an upper elementary tube can be traced only as far as the lower esophagus. on it ended in the upper stomach.
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no acute cardiopulmonary abnormality.
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low lung volumes with patchy opacities the lung bases, potentially atelectasis, but infection cannot be excluded. probable mild pulmonary vascular congestion.