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A central venous line in the right neck terminates at the level of the confluence of the brachiocephalic vein and superior vena cava. There is no pneumothorax or pleural effusion. The heart size is normal. Apparent prominence of the right hilus on this frontal projection is likely due to right middle lobe opacity as seen on the prior outside chest ct.
history: <unk>m with cvl // eval line placement
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Pa and lateral views of the chest provided. Lungs are better aerated. However, again seen is severe consolidation involving the entire right lung, not significantly changed since prior study. There is associated ipsilateral mediastinal shift and elevation of the right hemidiaphragm, again reflecting volume loss. The left lung is essentially clear. There is no pleural effusion. Right jugular and superior vena cava vein stent is again seen.
<unk> year old woman with multifocal pna with persistent fevers, hypoxia, now status post bronchoscopy
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The previously noted aortic stent, spinal hardware, and left ij central line is unchanged since prior exam. Bilateral small to moderate pleural effusions and bibasilar atelectasis are unchanged since the prior study. Mild cardiomegaly with new pulmonary vascular engorgement is noted. No new consolidations or pneumothorax. Left old rib fractures are again seen.
<unk> year old woman with history of thoracic spine infection, dyspnea, septic shcok // pulm edea, effusions
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The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is a coarse interstitial abnormality involving the mid-to-lower lungs to a greater degree on the left than right. How much of this appearance may be associated with pre-existing subpleural abnormalities that were partly visualized on the prior ct is uncertain since no prior radiographs are available for comparison. Mild-to-moderate relative elevation of the right hemidiaphragm compared to the left is similar to the prior examination. There are multiple air-fluid levels, probably in both small and large bowel seen in the upper abdomen, but no free air. Severe degenerative change involves the right shoulder including apparent effacement of the acromiohumeral interval, spurring along the glenohumeral joint and mild acromioclavicular narrowing.
hypotension.
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Pa and lateral views of the chest were obtained. Hyperexpansion of the lungs is again seen. There is no evidence of pneumonia, pulmonary edema, pleural effusion or pneumothorax. Cardiomediastinal silhouette is unremarkable. Post-surgical changes in the right lower lobe are again seen with chain sutures abutting the oblique fissure. A right port-a-cath is in standard position, terminating in the low svc.
<unk>-year-old female with pneumonia. evaluation for resolution of pneumonia.
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Heart size is mildly enlarged. The aorta is unfolded. Hilar contours are unremarkable. Pulmonary vasculature is not engorged. Linear and streaky opacities in the lung bases likely reflect areas of atelectasis. No focal consolidation, pleural effusion or pneumothorax is present. There are mild multilevel degenerative changes in the thoracic spine.
<unk> year old woman with <num> week history of cough
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Heart size is normal. Cardiomediastinal silhouette and hilar contours are normal. Lungs are clear. Pleural surfaces are clear without effusion or pneumothorax.
strangulated internal hernia. preoperative evaluation.
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Cardiac, mediastinal and hilar contours are within normal limits. Aortic knob calcifications are present. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. There are no acute osseous abnormalities.
cough.
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Pa and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.
<unk>m with allergice reaction, hypertension and now shortness of breath
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Frontal and lateral radiographs of the chest demonstrate well expanded, clear lungs. The cardiomediastinal and hilar contours are unchanged. The aorta is tortuous. There is no pneumothorax, pleural effusion, or consolidation.
history: <unk>f with palpitations // acute process?
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Comparison is made to prior study from <unk>. There is an endotracheal tube whose distal tip is <num> cm above the carina. There is a right ij central line with distal lead tip in the mid svc. Nasogastric tube tip is not well seen. The heart size is enlarged. There is pulmonary edema which is stable. More focal area of opacity is seen at the right base, stable.
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The study is severely limited by patient body habitus. Within this limitation, there are worsening rounded opacities in the right mid and lower lung. On the lateral radiograph, there is a large opacity posteriorly, also likely in the right lung, although not definitely confirmed on the frontal projection. Large left pleural effusion has likely increased in size. Moderate cardiomegaly persists. There may be a background of mild pulmonary edema. There is no evidence of large pneumothorax.
dyspnea. evaluate for pneumonia.
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Little change in the appearance of heart and lungs. Cardiac silhouette is within normal limits in a patient with intact midline sternal wires. No vascular congestion or pleural effusion or acute focal pneumonia.
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As compared to the previous radiograph, there is no relevant change. Moderate cardiomegaly without pulmonary edema. No pneumonia, no pleural effusions. Moderate tortuosity of the thoracic aorta. The sternal wires are in unchanged alignment.
status post liver transplant and copd. evaluation for pneumonia.
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Pa and lateral chest views were obtained with patient in upright position. Comparison is made with the next preceding pa and lateral chest examination of <unk>. On the present frontal view, the patient makes a very poor inspirational effort resulting in high positioned diaphragms and thereto related crowded appearance of the basal pulmonary vasculature. Heart size is not increased and no pulmonary vascular congestion has developed. As before, a permanent pacer is located in left anterior axillary position being connected to a total of three intracavitary electrodes. One of these is an icd device that terminates in the right ventricle. A second line is a probably abandoned old right ventricular electrode. A third electrode terminates in the right atrium lateral posterior wall area and is located in unchanged position and comparison is made with the previous examination one and a half years ago. Appearance of lungs is unchanged paying attention to differences in inspiratory degree. Acute parenchymal infiltrates or interstitial fibrosis changes cannot be identified. No pneumothorax is seen in the apical area. The lateral and posterior pleural sinuses remain free.
<unk>-year-old male patient with ventricular tachycardia, icd on amiodarone, evaluate for infiltrate related to amiodarone toxicity.
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Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is unchanged pleural thickening along the left costophrenic angle. There is no focal lung consolidation.
<unk> year old man with + ppd, no symptoms, evaluate for tb.
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Bilateral areas of opacification and consolidation are essentially unchanged from the prior study of <unk>. The endotracheal tube ends <num> cm from the carina, and the right-sided picc line ends in the low svc. There is no pneumothorax or pleural effusion. The cardiomediastinal silhouette is mildly enlarged.
<unk> year old man with tbi and spine fracture with pneumonia // pneumonia
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The heart is normal in size. Patchy calcification is noted along the aortic arch. Otherwise, the mediastinal and hilar contours appear within normal limits. The lungs appear clear. There no pleural effusions or pneumothorax.
dyspnea.
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Ap and lateral views of the chest demonstrate persistent mild cardiomegaly, unchanged since the prior study. Bibasilar atelectasis is present. There is no overt pulmonary edema, pneumothorax, pleural effusion or focal consolidation concerning for pneumonia. There has been interval removal of a hemodialysis catheter. Median sternotomy wires are again noted.
<unk>-year-old female status post fall with tachycardia. evaluation for acute process.
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In comparison with the study of <unk>, there has been placement of a large-bore catheter from the right ij region that extends into the right atrium. Otherwise, the monitoring and support devices are essentially unchanged. Hazy opacification in the left hemithorax is consistent with substantial volume loss in the left lower lobe with some layering pleural effusion. Mild atelectatic changes are again seen at the right base. Cardiomediastinal silhouette is unchanged.
strep pneumonia with intubation.
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Left-sided port-a-cath is re- demonstrated with tip in the proximal right atrium, unchanged. Lung volumes remain low with moderate enlargement of the cardiac silhouette appearing unchanged. Mediastinal and hilar contours are unremarkable. Crowding of the bronchovascular structures is present though no overt pulmonary edema is seen. Linear opacities in the right upper lobe are compatible with post radiation changes. Patchy and linear opacities in the lung bases likely reflect a combination of chronic interstitial lung disease and atelectasis. No new focal consolidation is present. Elevation of the right hemidiaphragm is again noted, and a subpulmonic effusion may be present. There is no new pleural effusion or pneumothorax. No acute osseous abnormality is visualized. Clips are seen in the right axilla, and the patient is status post bilateral breast reconstruction.
history: <unk>f with dyspnea
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The heart is upper limits normal in size. The aorta is mildly tortuous. The hila appear normal. There are minimal degenerative changes of the spine with this endplate sclerosis and small osteophytes. The lungs are clear without infiltrate or effusion.
hypertension question heart failure.
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As compared to the previous radiograph, the patient has been intubated. The tip of the endotracheal tube projects approximately <num> cm above the carina. The apical part of the left lung is partially ventilated. The basal part is still collapsed, following still present left pleural effusion. No change in appearance of the right lung.
left lung collapse, status post bronchoscopy.
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The lungs are clear. There is no consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. Gastric band is noted as well surgical clips in the right upper quadrant.
<unk>f with chest pain // eval for cause of chest pain
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Very small left apical pneumothorax has minimally decreased in size since the prior radiograph. Cardiomediastinal contours are stable in appearance. Persistent small bilateral pleural effusions with focal loculated component of left effusion in the upper left hemithorax peripherally. Adjacent areas of atelectasis are present at the lung bases.
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Pa and lateral chest radiographs. The lung volumes are low. There is no focal consolidation, effusion, pneumothorax. There are no new abnormal cardiac and mediastinal contours. Coronary calcifications are again noted.
fall
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Increased lung markings in the right lower lobe that may be due to a focal area of volume loss or early infiltrate. Attention should be paid to this area on followup.
hiv, pleuritic chest pain, shortness of breath.
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Frontal and lateral views of the chest. Improved lung volumes are seen on the current exam. The lungs are clear of consolidation, effusion, or pulmonary vascular congestion. Left chest wall dual lead pacing device is again seen with leads in expected locations. Multiple old right lateral rib fractures are again noted.
<unk>-year-old female status post syncope.
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Et tube is in appropriate position with its tip <num> cm above the carina. Retrocardiac opacity is seen. Diffuse opacity overlying the right hemi thorax is consistent with a layering effusion. No pneumothorax. Heart size is normal or mildly enlarged.
history: <unk>m with intubated // eval for ett placement
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Cardiac size is normal. Peribronchial opacities in the left perihilar region have minimally increased. There is no pneumothorax or pleural effusion.
<unk> year old man with leukocytosis and ams // ?pna
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Heart size is normal. Mediastinal and hilar contours are normal. Pulmonary vasculature is not engorged. Lungs are clear. No pleural effusion or pneumothorax is present. No subdiaphragmatic free air is seen. Multiple clips are noted in the left upper quadrant of the abdomen. No acute osseous abnormalities are detected.
history: <unk>m with history of necrotizing pancreatitis, presents with high luq pain // please eval for free air
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Lung volumes are low causing crowding of the central bronchovascular structures. The heart is normal in size given the low lung volumes. There is a right internal jugular central venous line which terminates in the proximal right atrium. An enteric tube terminates below the view of this radiograph. There is an endotracheal tube which terminates approximately <num> cm above the level the carina. Gaseous distention of bowel loops is noted in the upper abdomen.
<unk>-year-old female intubated status post transfer. evaluate for tube placement.
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The cardiac, mediastinal and hilar contours appear unchanged. There is no pleural effusion or pneumothorax. The lungs appear clear. A right-sided picc line terminates in the upper superior vena cava.
cough and weakness.
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Frontal and lateral views of the chest were obtained. There is minimal left base atelectasis. A lateral right mid lung calcified granuloma is stable. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable and unremarkable. The cardiac silhouette is top normal. The aorta is calcified and tortuous. Osteophytosis is seen along the lower thoracic spine.
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Endotracheal tube, nasogastric tube, right ij and left ij central venous catheters are in satisfactory position. Diffuse pulmonary opacities are likely in total unchanged with slight worsening in the bases likely reflective of supine technique. The heart size is mild to moderately enlarged.
<unk>-year-old woman with ards, intubated with og tube, assess position.
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As compared to the previous radiograph, there is no relevant change. The right chest tube is in unchanged position. Unchanged position of all other monitoring and support devices. Currently, there is no indication for the presence of a pneumothorax. Unchanged extent of the relatively large left pleural effusion with left associated atelectasis. Minimal fluid overload. Unchanged appearance of the cardiac silhouette.
pneumothorax after chest tube. evaluation.
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There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities are detected.
<unk>f with sob // sob
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In comparison with prior exam, there is still mild pulmonary edema although this appears to have slightly improved. Bilateral basilar opacities are consistent with atelectasis. Endotracheal tube terminates <num> cm from the carina. Right chest tube has been repositioned apically since the prior study. There is no pneumothorax.
<unk>-year-old woman status post right lung biopsy.
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Posterior right base opacity is seen, which may be due to atelectasis or pneumonia. No large pleural effusion is seen. There is no pneumothorax. The cardiac silhouette is top-normal. Mediastinal contours are unremarkable.
history: <unk>m with sickle cell anemia here in sickle cell crisis.
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Cardiomediastinal contours are normal. The lungs are clear. There is no pneumothorax or pleural effusion. The osseous structures are unremarkable
<unk> year old man with cough // infiltrate?
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Left chest tubes are in unchanged position. The left apical pneumothorax is no longer visualized. Bilateral small pleural effusions greater on the left than the right persist. An opacity at the right lung base could reflect atelectasis; however, in the correct clinical setting aspiration or infection are possible. Stable opacity in the left lower lung.
<unk> disease. these with recent aspiration treated for pneumonia to days ago now presenting with left-sided loculated pleural effusion status post attempted chest tube placement by interventional pulmonology, unsuccessful now status post left vats and decortication. evaluate effusion and pneumothorax.
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Tip of endotracheal tube is in standard position, and nasogastric tube terminates below the diaphragm. As compared to the recent radiograph, there has been development of mild pulmonary vascular congestion accompanied by minimal interstitial edema. Partial atelectasis of the left lower lobe is also worse compared to the prior study. Left-sided small pleural effusion versus pleural thickening is similar.
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The lungs are low. Bibasilar atelectasis is seen. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable.
history: <unk>m with fall, right rib pain // eval for rib fx, right anterior
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Patient is status post median sternotomy and cabg. Coronary artery stenting/calcification is seen. The cardiac silhouette is top-normal to mildly enlarged. No focal consolidation is seen. There is perihilar, peribronchial wall thickening which can be seen in small airways disease. No pleural effusion or pneumothorax is seen. Degenerative changes are seen along the spine.
history: <unk>m with chest pain and cough // ? pna
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Median sternotomy wires and prosthetic mitral valve are in unchanged positions. Lumbar kyphoplasty is again noted. Widened mediastinum and increased interstitial markings in bilateral perihilar regions are similar to before and consistent with interstitial lung disease which was better evaluated on prior ct. Lung volume is low. No new area of consolidation is identified. There is no pleural effusion or pneumothorax. Mildly enlarged cardiac silhouette is unchanged.
<unk>f with shortness of breath, cough. history of pulmonary fibrosis/ eval for pneumonia
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Bilateral pulmonary nodules and masses are noted compatible with history of metastatic ovarian cancer. Superimposed infection would be difficult to exclude given extensive disease. Cardiac silhouette is within normal limits. Increased soft tissue density at the lower right paratracheal region likely due to some component of underlying adenopathy. No acute osseous abnormalities.
<unk>f with dyspnea // ?pneumonia. additional history ed note is known metastatic ovarian cancer.
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The lungs are clear. The cardiomediastinal silhouette is within normal limits. Slight height loss of a lower thoracic/upper lumbar thoracic vertebral body is unchanged from prior abdominal ct.
<unk>f with near syncopal, weakness // r/o acute process
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Lung volume is low. There is no pneumothorax. There is plethora of interstitial markings, which is unclear if due to pulmonary edema with crowding of vessels or superimposed aspiration. There is a left chest tube. Subcutaneous air is noted in the left thorax. Trachea makes sharp right turn at the level of thoracic inlet which is chronic.
<unk> year old man with lul nodule s/p wedge resection // eval post operative change
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There are confluent bibasilar opacities due to a combination of right pleural effusion bilateral consolidations suspicious for infection and probable atelectasis. Given differences in technique, there has been no dramatic interval change. Tracheostomy tube is noted. Calcified mediastinal lymph nodes are also visualized. Cardiomediastinal silhouette is unchanged. Median sternotomy wires are intact. Right-sided dual-lumen central venous catheter tip is within the right atrium. Right picc tip is also likely in the upper right atrium
<unk>m with trach/peg, c/f stomach contents on suction, desating // aspiration
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Compared to the previous radiograph, there is no relevant change. Extensive bilateral parenchymal opacities unchanged severity, combined to cardiac atelectasis, moderate cardiomegaly and the potential presence of small pleural effusions. No newly appeared focal parenchymal opacity.
multilobar pneumonia, pleural effusions, increased shortness of breath, evaluation.
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Overall, the appearance of the lungs is similar compared to the prior study, with low lung volumes and areas of bilateral pulmonary opacity which may be due to mild edema superimposed on chronic lung disease. Cardiac and mediastinal silhouettes are grossly stable. No pleural effusion or pneumothorax is seen.
history: <unk>f with chf, ild, breast mass*** warning *** multiple patients with same last name! // cardiac workup
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The lungs are clear without consolidation or edema. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. No fracture is identified.
chest pain.
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Lung volumes are low leading to crowding of the bronchovascular structures. There is no lobar consolidation, pleural effusion, pneumothorax, or pulmonary edema. The heart is normal in size. The aorta is unfolded.
history: <unk>m with seizure // pna?
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Since the prior radiograph from <unk>, there is development of thickened airways in the left upper, left lower, and right lower lungs, which are not accompanied by discrete areas of consolidation. Instead, there is increased interstitial opacification in these areas. There is no pleural effusion or pneumothorax. Heart size and mediastinal contours are normal.
history: <unk>f with cough/wheezing/fever and diffuse rhonchi x <num> days // ? pneumonia
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A port-a-cath terminates in the lower superior vena cava. The cardiac, mediastinal and hilar contours appear unchanged. There is a moderate left-sided pleural effusion, similar to perhaps increase since the prior abdominal ct. However, much of the apparent left basilar opacification is associated with moderate relative elevation of the left hemidiaphragm and probably atelectasis. There is no evidence of free air.
advanced colon cancer, presenting with weakness, nausea, vomiting, and diarrhea.
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There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. The imaged upper abdomen is unremarkable. The bones are intact.
history: <unk>m with chest wall pain s/p mvc // ? fx
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Frontal and lateral views of the chest. The lungs are hyperinflated. Biapical scarring is again noted. There is no consolidation or effusion. The cardiomediastinal silhouette is within normal limits. Mid thoracic dextroscoliosis is again noted. No free air is seen below the diaphragm. Surgical clips project over the right breast.
<unk>-year-old female with epigastric pain.
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The lungs are clear. Mediastinal and cardiac contours are within normal limits. There is no pneumothorax or pleural effusion. Degenerative change of the thoracic spine is unchanged.
patient with fever and cough, rule out pneumonia.
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Ap portable upright view of the chest. Cardiomegaly is mild. There is calcification projecting over the left heart likely mitral annular calcification. There is no focal consolidation, large effusion or pneumothorax. There is a levo scoliotic curvature of the l lower thoracic and lumbar spine partially imaged. Otherwise bony structures appear unremarkable.
<unk>f with chest pain, shortness of breath, productive cough
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The lungs are clear though lung volumes are low. Allowing for this, there is no focal opacity, evidence of pulmonary edema, pleural effusion or pneumothorax. The cardiac and mediastinal contours are normal. There is no free air beneath the right hemidiaphragm.
<unk>f with ams // r/o pna
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Single portable semi-erect frontal chest radiograph demonstrates mildly hypoinflated lungs. No focal opacity. No pleural effusion or pneumothorax. Mild cardiomegaly with a tortuous thoracic aorta is again noted. Atherosclerotic calcifications of aortic arch are present. Moderate hiatal hernia is noted. Limited assessment of the upper abdomen is unremarkable.
<unk> year old woman with r fnf. preop surg: <unk> (r hip hemi)
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Since <unk>, bilateral small pleural effusions are stable and moderate compressive atelectasis is mildly increased. Mild pulmonary vascular congestion is noted. Superimposed pneumonia cannot be excluded in the appropriate clinical setting. Again seen is enlargement of the main pulmonary artery. The heart size is stable. No pneumothorax.
<unk> year old woman w/hx of sma thrombosis pod<unk> s/p lsc loa/rso/d c with worsening cough and crackles on lung exam, afebrile. // please assess for worsening pulmonary edema vs pneumonia, less likely pe
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Lungs are fully expanded and clear. There is no focal consolidation, effusion, or pneumothorax. Specifically, there is no evidence of mediastinal or hilar lymphadenopathy or parenchymal abnormalities. Mediastinal and hilar contours are normal. Heart size is normal.
<unk> year old man with prostate bx showing signs of sarcoidosis // evidence of sarcoidosis
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As compared to the previous radiograph, there is a reduction in lung volumes and an increase in pleural effusions. In addition, the lung parenchyma appears essentially denser on the right. This could reflect increasing pulmonary fluid overload. The areas of atelectatic regions the lung bases have increased in extent. The monitoring and support devices are unchanged. At the time of dictation, the referring physician, <unk>, was paged for notification at <time> a.m., <unk>.
evaluation for interval change.
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Heart is upper limits of normal in size with left ventricular configuration. The thoracic aorta is tortuous and both the ascending and descending regions, similar to the prior study. Patchy opacities in the left retrocardiac region have improved since <unk> in show more substantial improvement when compared to earlier radiograph of <unk> and <unk>. Small left pleural effusion is again demonstrated.
<unk> year old man with persistent cough // exclude hf, pna, effusions
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The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There are horizontal linear opacities in the right costophrenic sulcus which are nonspecific. Possibilities include scarring; an acute process such as vascular congestion, while not entirely excluded, is doubted given the fact that the pulmonary vascularity is otherwise within normal limits. There is a patchy opacity obscuring the left hemidiaphragm but most suggestive of minor atelectasis or scarring. There is mild leftward convex curvature centered at the thoracolumbar junction.
palpitations.
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The lungs are well expanded. Minimal engorgement of the right hilum is not significantly changed from prior. Otherwise, there are no focal opacities. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. Sternotomy wires and surgical clips in the mediastinum from prior surgery are unchanged in appearance.
patient with chest pain. evaluate for pneumonia or chf.
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The patient is status post recent aortic and mitral valve replacements with intact sternotomy wires. Massive cardiomegaly is unchanged. A small left pleural effusion is unchanged. There is no pneumothorax.
<unk>-year-old male status post avr and mvr; evaluate left lower lobe.
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The heart size is normal. The hilar and mediastinal contours are within normal limits. Tortuosity of the thoracic aorta is unchanged in configuration since the prior radiograph from <unk>. There is no pneumothorax, focal consolidation, or pleural effusion.
preoperative evaluation.
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Supine and two cross-table lateral chest radiographs are severely limited by the patient's markedly abnormal body habitus secondary to osteogenesis imperfecta. The aeration of the left lung has improved since yesterday's exam. No pneumothorax is identified. The bones are diffusely demineralized with extensive osseous deformities. A large volume of bowel gas is noted.
<unk> yom with osteogenesis imperfecta, presenting with back pain and dyspnea.
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Single portable chest radiograph was provided. A left picc continues to be within the lower right atrium and should be retracted for better positioning. Nasogastric tube courses below the diaphragm and terminates in the stomach. Lungs are clear without focal consolidation, pleural effusion or pneumothorax. The heart is mildly enlarged, likely projectional. Bones are intact. Imaged upper abdomen is unremarkable.
<unk>-year-old man with altered mental status. evaluate interval change.
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Frontal and lateral views of the chest were obtained. There is minimal left base atelectasis. Dual-lead left-sided pacemaker is again seen with leads in the expected positions of the right atrium and right ventricle. The cardiac and mediastinal silhouettes are stable with the cardiac silhouette enlarged. The aorta is calcified and tortuous. The bones are osteopenic. Possible trace fluid in major fissure.
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The cardiomediastinal and hilar contours are within normal limits. Lungs are well expanded and clear. There are no focal consolidations, pleural effusions, pulmonary edema or pneumothorax. A right ij venous catheter terminates at the cavoatrial junction. The osseous structures are grossly intact.
<unk>-year-old male patient with cutaneous lymphoma status post bone marrow transplant nine months ago, now with cough and low-grade fevers. study requested for assessment of pneumonia.
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Frontal and lateral views of the chest were obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. No displaced fracture is seen.
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There are small right greater than left bilateral pleural effusions. Pulmonary vascular congestion is seen. The cardiac silhouette is enlarged. Right mid to lower lung opacity is seen and consolidation may be present. Evidence of dish is seen along the spine.
history: <unk>f with dyspnea // eavl chf vs. pna
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The patient's body is laterally flexed to the right with slight distortion of the thoracic cage. The right hemidiaphragm is elevated and there are opacities in the right infrahilar region. This could be atelectasis or aspiration, difficult to fully assess. No pneumothorax. The left lung is clear. The heart is normal in size.
<unk>-year-old woman with overdose of seroqual and sleeping now desat to <unk>% concerned for aspiration. evaluate for aspiration.
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Compared with prior radiographs on <unk>, there is an increase in left basilar atelectasis and probable effusion. Right basilar atelectasis is unchanged. No pneumothorax. Cardiomediastinal silhouette is unchanged. A dobhoff tube is better positioned, terminating in the stomach. Left pleural drain is unchanged.
<unk> year old man with rll infiltrate s/p bronchoscopy for aspiration event // please evaluate for interval change
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Cardiac silhouette size appears borderline enlarged, unchanged. Mediastinal and hilar contours are stable. Lungs are clear without focal consolidation, pleural effusion or pneumothorax. Pulmonary vasculature is normal. No acute osseous abnormality is detected.
history: <unk>f with crescendo left chest pain
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There is a loculated pleural effusion in the right upper lobe. New tiny left apical pneumothorax. Small bilateral pleural effusions are improved from <unk>. Normal lung volumes. Post surgical changes in the right lower lobe. Cardiomediastinal borders and hilar structures are normal
<unk> year old woman with biopsy proven lung cancer s/p right vats/robotic middle lobectomy // assess for interval change
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The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. Bony structures appear within normal limits.
chest pain and shortness of breath.
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As compared to the previous radiograph, the left chest tube is in unchanged position. The left pleural effusion is unchanged in appearance as is the atelectasis in the retrocardiac lung areas. On the right, the pre-existing effusion might have minimally increased. No other interval changes.
left pleural effusion, evaluation for interval change.
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Pa and lateral chest views were obtained with patient in upright position. Analysis is performed in direct comparison with the next preceding pa and lateral chest examination of <unk>. Heart size remains normal. No configurational abnormality is seen. Thoracic aorta unremarkable. The pulmonary vasculature again does not demonstrate any congestive pattern and the lateral and posterior pleural sinuses are free from any fluid accumulation. No pneumothorax is present in the apical area on the frontal view. In comparison with the next preceding chest examination the at that time visible pulmonary abnormalities seen in the right upper lobe area laterally and in contact with the pleura as well as similar changes in the left base have clearly regressed. No new parenchymal abnormalities are present. No remaining abnormality at the site of the previously performed wedge resection in the right upper lobe area.
<unk>-year-old female patient with pulmonary nodules status post right vats, upper lobe wedge resection, assess for interval change.
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The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. There is again mild reversed s-shaped curvature to the thoracolumbar spine.
chest pain, shortness breath, and altered mental status.
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Cardiomediastinal silhouette is normal. There is no pleural effusion or pneumothorax. There is no focal lung consolidation.
<unk>f with tachycardia, cough, sore throat for <num> days, evaluate for pneumonia..
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Cardiac silhouette is enlarged, and accompanied by mild pulmonary vascular congestion. Moderate right pleural effusion has apparently slightly increased in size in the interval and is accompanied by adjacent basilar atelectasis. Left retrocardiac atelectasis has slightly worsened and is accompanied by a probable small left pleural effusion.
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There is a small left pneumothorax which is stable in size compared to prior study. Architectural distortion with linear and pleural opacities at the right apex is stable and consistent with history of prior treatment. There is also a right lower lung nodule, better seen on the ct scan dated <unk>. Cardiomediastinal and hilar contours are stable. Left chest port remains with tip in the low svc.
<unk>-year-old with small cell lung cancer and left-sided pneumothorax. evaluate interval change.
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In comparison with the study of <unk>, there is increased indistinctness of engorged pulmonary vessels, consistent with elevated pulmonary venous pressure. In addition, there are bibasilar opacifications with poor definition of the hemidiaphragms, more prominent on the right. This suggests pleural effusion with underlying compressive atelectasis.
cirrhosis, after radiofrequency ablation.
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Single lead icd terminates near the cardiac apex. No pneumothorax. Heart size and mediastinum are stable. No pleural effusion. Lungs clear.
<unk> year old woman with cm s/p single chamber icd // lead position
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Elevation of the right hemidiaphragm is of unknown chronicity. There is additional right basilar opacity which could reflect compressive atelectasis. Patchy left basilar opacity may also reflect additional site of atelectasis. Heart size is difficult to assess but is at least mildly enlarged. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is not engorged. There is no pneumothorax or pleural effusion. Moderate multilevel degenerative changes are noted in the imaged thoracolumbar spine.
history: <unk>m with copd, with hypoxia
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Frontal and lateral views of the chest. The lungs are clear of focal consolidation, effusion, or pulmonary vascular congestion. Cardiac silhouette is top normal in size. No acute osseous abnormality is detected.
<unk>-year-old male with hypertension, hyperlipidemia and melanoma presenting with fevers and chest pain.
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Lung volumes are low. No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is detected. Retrocardiac opacity on frontal view likely represents atelectasis. Heart size is slightly enlarged but likely exaggerated by low lung volumes. Mediastinal contours are within normal limits.
<unk>-year-old female with cough.
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The dobhoff tube is seen passing below the ge junction, however it should be advanced <num>-<num> cm. There is a left ij, which terminates in the mid svc. There is a left basilar chest tube, which appears unchanged in comparison to the prior chest radiograph. The sternotomy wires appear intact and in appropriate alignment. The bilateral pleural effusions and moderate vascular congestion is unchanged. Heart size is stable. The mediastinal and hilar contours are stable. No pneumothorax is seen. There are no acute osseous abnormalities.
<unk>: <unk>m w htn, dm, cad s/p cabgx<num>, esrd s/p renal tpx x <num> admitted <unk> w nstemi, chf exacerbation, hcap who presented with closed loop obstruction, s/p ex-lap, jejunal resection now s/p duod-jejun anastamosis and closure on <unk> // dobhoff placement. will need serial films.
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Assessment is limited by patient positioning and the patient's chin and neck obscure evaluation of the medial aspect of the upper lobes. Given these limitations, the heart size remains mildly enlarged. Extensive esophageal varices account for the abnormally widened lower mediastinal contour which appears grossly unchanged. Lung volumes are low. Crowding of bronchovascular structures is demonstrated without overt pulmonary edema. Streaky bibasilar airspace opacities may reflect atelectasis. No focal consolidation, pleural effusion or large pneumothorax is demonstrated. Multiple calcified gallstones are again noted in the right upper quadrant of the abdomen.
history: <unk>f with altered mental status
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Heart size, mediastinal and hilar contours are normal, and lungs are clear. Percutaneous feeding tube is seen in the upper abdomen.
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Ap and lateral chest radiographs. Right picc tip is in the lower svc. The lungs are clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal.
evaluation of picc line placement.
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The right-sided chest tube is been removed. There is a new left mid lung infiltrate. There continues to be dense right lower lobe infiltrate and volume loss with associated effusion. There is a small left effusion. There is mild pulmonary vascular congestion. The cardiac size continues to be moderately enlarged
<unk> year old man with chronic right pleural effusion, afib (on amio) now with bilateral pulmonary infiltrates (at osh) with pulm consults concerned for amio toxicity. now hypoxic on nrb. // eval for pulm edema vs pneumonitis vs effusion
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Lung volumes are low, but the lungs are clear. An opacity at the lateral left lung base is likely due to prominent epicardial fat. There is no pneumothorax. The heart and mediastinum are within normal limits. Generalized osteopenia is unchanged. There is new mild gaseous distention of the stomach. Prominent supraclavicular soft tissues with slight leftward deviation of the cervical trachea is likely due to a mildly enlarged thyroid gland.
<unk> year old woman with advanced dementia, non-verbal with acute onset of increased work of breathing and tachypnea // evaluate for pulmonary edema vs evidence of aspiration
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Frontal and lateral views of the chest were obtained. There are moderate bilateral pleural effusions with overlying atelectasis. Slight increase in the interstitial markings bilaterally may be due to mild interstitial edema. The cardiac silhouette is enlarged. The aorta is calcified and tortuous. The patient is status post median sternotomy and cardiac valve replacement.
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Left moderate and small right pleural effusions are seen without focal consolidation or pneumothorax. Heart size is top-normal with tortuous aortic contour. Median sternotomy wires are intact.
shortness of breath status post aortic dissection repair <num> weeks ago. assess for pneumonia.
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Heart appears mildly enlarged. The aorta is moderately tortuous. Mediastinal and hilar contours are otherwise unremarkable. There is no pleural effusion or pneumothorax. The lungs appear clear.
cough.