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Pa and lateral views of the chest demonstrate clear and well-expanded lungs bilaterally. No evidence of airspace consolidation. There are no pleural effusions identified. No pneumothorax. Mild peribronchial thickening suggests small airway disease. Heart is top normal in size, unchanged since <unk>. Hilar contour is within normal limits. Osseous structures are without acute abnormality.
<unk>-year-old female with chest pain.
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Pa and lateral views of the chest demonstrate the lungs are well expanded and clear. A trace amount of linear atelectasis is present at the left lung base. No focal opacity concerning for pneumonia is identified. Aortic knob calcifications are again seen. The cardiomediastinal silhouette is unremarkable. No pulmonary edema or pleural effusion. No pneumothorax is identified.
<unk>-year-old female with nausea and vomiting. evaluation for pneumonia.
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Left pectoral aicd with intact leads seen projecting over the right atrium and right ventricle. Minimal left basilar atelectasis. A linear, <unk>-<unk> opacity is seen in the retrocardiac region, corresponding to an area of pneumonia in <unk>, and likely representing a residual scar. No pleural effusion, pneumothorax, or pulmonary edema is identified. Stable, mild cardiomegaly. Mediastinal hilar contours are normal.
vt on amiodarone, evaluate for toxicity.
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There is no radiograph available for comparison. Normal size of the cardiac silhouette. No pneumonia. No pulmonary edema. No pleural effusions or other acute or chronic lung parenchymal changes. Normal hilar and mediastinal contours.
depression, questionable pneumonia.
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The lung volumes are normal. There is normal shape of the hemidiaphragms. No pleural effusions. Normal size of the cardiac silhouette without evidence of pulmonary edema. No pneumonia. No pneumothorax.
admitted for the rule out of acute chest processes.
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There is mild cardiomegaly. The mediastinal contour is unremarkable. Left perihilar and bibasilar alveolar opacities are noted, concerning for moderate asymmetric pulmonary edema, but pneumonia is not excluded. No large pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities.
shortness of breath, tachycardia.
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In comparison with the study of <unk>, the tip of the nasogastric tube is difficult to see. It extends into the upper stomach where it crosses the lower margin of the image. However, the position of the side hole is impossible to evaluate. If this is clinically significant, a repeat study of the lower chest and upper abdomen using abdomen technique would be recommended. Little change in the cardiomegaly and pulmonary edema. The possibility of supervening pneumonia would have to be considered in the appropriate clinical setting.
ng tube pulled out, now replaced.
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Frontal and lateral views of the chest were obtained. The heart is of normal size with normal cardiomediastinal contours. There is calcification of the aortic knob. The lungs are clear without focal or diffuse abnormality. No pleural effusion or pneumothorax. No acute rib fracture is present. Patient is status post lower lumbar vertebroplasty. Several wedge compression deformities of several thoracic and lumbar vertebral bodies are new or worsened since <unk>. No radiopaque foreign body.
<unk>-year-old female with left-sided posterior chest wall pain. evaluate for rib fractures.
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There is no focal consolidation, pleural effusion or pneumothorax identified. The size of the cardiomediastinal silhouette is within normal limits.
<unk> year old man with acute liver failure // please evaluate for infiltrate
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Pa and lateral views of the chest provided. Right upper extremity access picc line is noted with its tip in the upper svc. The lungs appear clear without focal consolidation, large effusion or pneumothorax. Cardiomediastinal silhouette appears stable. Mild pulmonary vascular congestion persists. Bony structures are intact. No pneumothorax or large effusion.
<unk>m with picc line for iv abx
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Ap portal view of the chest. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal.
chest pain.
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New opacification on the left lower lung, without air bronchograms, consistent with atelectasis and/or effusion. The right lung is clear. No focal consolidation to suggest pneumonia. Bilateral pulmonary vascular engorgement without pulmonary edema. No pneumothorax. The heart is top-normal in size, unchanged. Stable mediastinal and hilar contours. The upper thoracic and lower cervical spine fixation devices appear intact and unchanged in position. The left picc terminates in the region of the cavoatrial junction, as before.
<unk>-year-old woman with increased respiratory secretions; evaluate for pneumonia or pulmonary edema.
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Low lung volumes cause bronchovascular crowding. There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal contour is normal.
<unk>m with chest pain, evaluate for etiology of chest pain.
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Portable semi-upright radiograph of the chest demonstrates low lung volumes which results in bronchovascular crowding. There is bibasilar atelectasis. The cardiomediastinal and hilar contours are unchanged. No pneumothorax, pleural effusion, or consolidation. No evidence of pulmonary edema.
history: <unk>f with hypoxia // eval for pulm edema
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The cardiac, mediastinal and hilar contours are unchanged with the heart size within normal limits. Calcified left hilar lymph nodes as well as calcifications within the medial aspect of the left upper lung field are unchanged compatible prior granulomatous disease. Pulmonary vascularity is not engorged. The lungs are hyperinflated with relative lucency in the lung apices compatible with underlying emphysema. Previously noted right lower lobe opacity has resolved. No focal consolidation, pleural effusion or pneumothorax is identified. Scattered calcified granulomas are also noted within the lungs. Partial resection of the <unk> right posterior rib is again noted. There are no acute osseous findings.
shortness of breath and coarse breath sounds.
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A single portable ap upright view of the chest was obtained. Moderate-to-severe cardiomegaly is again noted. Cardiomediastinal contour is unchanged. There is no pulmonary edema. In comparison to the prior study, however, there is increased opacification at the right base. There is no pleural effusion or pneumothorax. Sternotomy wires and surgical clips noted.
<unk>-year-old man with new hypoxia while in ed, evaluate for edema or pneumonia.
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The lungs are well expanded and clear. Hila and cardiomediastinal contours and pleural surfaces are normal. Azygos lobe noted incidentally, a normal variant. No osseous abnormality within the limits of plain radiography.
<unk>m with chest pain and left arm pain (more like soreness) since earlier tonight.
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Bilateral mid to lower lung zone predominant airspace opacification is again noted and essentially unchanged. Consolidation of the left lower lobe. Susepcted superimposed pulmonary edema. Effusions are small if any. Upper lobe empysema. Heart size is unchanged.
<unk> year old man with hx of aspiration pneumonia on abx, had probable aspiration event last night. // please evaluate for interval changes
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The cardiac silhouette and pulmonary vasculature are unremarkable. There are small, bilateral pleural effusions. Midline sternotomy wires are intact and well aligned. Evidence of prior left rib trauma is noted. There has been interval removal of a right-sided internal jugular sheath.
<unk> year old man with s/p cabg // eval postop changes
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The left subclavian catheter extends to about the level of the cavoatrial junction. No evidence of pneumothorax. The lungs are essentially clear.
subclavian catheter placement.
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The lungs are clear.the cardiac, hilar and mediastinal contours are normal.no pleural abnormality is seen.
<unk>f with shortness of breath. evaluate for pneumonia.
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In comparison with the study of <unk>, there is little overall change. Continued enlargement of the cardiac silhouette in a patient with prominent interstitial markings and intact midline sternal wires. The appearance could well reflect elevated pulmonary venous pressure, though some element of chronic interstitial lung disease would have to be considered.
dementia and alcohol abuse.
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A right ij central venous catheter ends at the cavoatrial junction. Heart size is normal. The lungs are clear. The pleural surfaces are normal. There is no pneumothorax.
<unk> year old man with aml undergoing allo-transplant, evaluate for any acute process
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The patient is status post coronary artery bypass graft surgery. The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The lungs appear clear.
chest pain.
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The tip of the endotracheal tube terminates <num> cm above the carina. There has also been interval placement of a right ij central venous catheter terminating in the mid svc. Lung volumes remain low without focal consolidation. The cardiomediastinal silhouette, hilar contours are stable. There is no pleural effusion or pneumothorax.
<unk> year old woman with cirrhosis, now with large gi bleed s/p intubation, evaluate for endotracheal tube placement.
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Comparison is made to the previous study from <unk>. There has been placement of a feeding tube with the distal tip in the body of the stomach. There is a right-sided central venous catheter with distal lead tip at the proximal right atrium. Median sternotomy wires are seen. Aortic valve replacement is also present. There is a persistent left retrocardiac opacity with atelectasis at the left lung base. This is stable.
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Lung volumes are unchanged compared to the prior study. The endotracheal tube is unchanged in position, terminating level clavicles. An orogastric tube terminates in the stomach, the side port is at the level of the gastroesophageal junction. A right internal jugular catheter terminates in the proximal svc. There is persistent mild cardiomegaly and prominence of the bilateral hila with upper lobe vascular congestion. Appearances are consistent with pulmonary vascular congestion, no overt pulmonary edema. Trace bilateral pleural effusions. No consolidation or pneumothorax seen.
<unk> year old man with ogt // pls eval ogt placement
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A large left pleural effusion appears slightly increased in size compared to the previous study. Cardiac and mediastinal contours unchanged. There is continued left basilar opacification likely reflective of compressive atelectasis. Mild pulmonary vascular congestion is present. Patchy right basilar opacity may reflect atelectasis though infection is difficult to exclude. No right-sided focal consolidation, pleural effusion or pneumothorax is detected. No acute osseous abnormality is present.
<unk> year old woman with hepatic encephalopathy
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Patient is status post left mastectomy with implant and right axillary clips. Heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. The lungs are clear. No pleural effusion or pneumothorax is identified. No pulmonary edema is demonstrated. Mild degenerative changes are noted within the imaged thoracic spine.
history: <unk>f with shortness of breath // r/o pneumonia
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The inspiratory lung volumes are decreased. There is mild increased opacification of the left lung base, which is most compatible with atelectasis. No focal airspace opacity concerning for pneumonia is detected. There is no significant pleural effusion or pneumothorax. The pulmonary vasculature is not engorged. The cardiac silhouette is mildly enlarged but stable. The mediastinal contours are unchanged from <unk> with tortuosity of the thoracic aorta. The hilar contours are within normal limits. The trachea is midline. There is no free air beneath the right hemidiaphragm.
cough and dyspnea, here to evaluate for acute cardiopulmonary process.
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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.
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Cardiac silhouette size is mildly enlarged, unchanged. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is normal. There is elevation of the right hemidiaphragm which is unchanged. Right basilar atelectasis or scarring is also similar. There is minimal left lower lobe streaky atelectasis. No focal consolidation, pleural effusion or pneumothorax is demonstrated. Several clips are noted projecting over the right upper quadrant of the abdomen. Bullet fragment is again noted projecting just to the left of midline within the upper abdomen.
history: <unk>m with chest pain
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Endotracheal tube tip lies approximately <num> cm above the carina. Nasogastric tube extends to the stomach, though the side hole is above the esophagogastric junction. There is some patchy opacification at the left base. Although this could merely be atelectasis, in the appropriate clinical setting, a developing pneumonia would have to be considered.
intubation.
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The new right subclavian line ends in the low svc. There is no pneumothorax. The left hilum is enlarged due to an enlarged left pulmonary artery better evaluated in prior ct. There is no focal consolidation, pleural effusion, or pulmonary edema. The cardiomediastinal silhouette is within normal limits.
<unk> year old woman with recent diagnosis of all <unk> chromosome positive with febrile neutropenia. // please evaluate for pulmonary process; rule out pneumonia.
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There appears to be a new linear density in the right middle lobe compared to the prior exam. There is no evidence of a pneumothorax or pleural effusions. The hilar and mediastinal contours are unremarkable. The heart is normal in size. The visualized osseous structures are unremarkable.
<unk>-year-old female with shortness of breath who presents for evaluation.
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The lungs are clear. There is no consolidation, effusion or edema. The cardiomediastinal silhouette is within normal limits. Descending thoracic aorta is tortuous with some vascular calcifications. No acute osseous abnormalities identified.
<unk>m with unclear hx, wheeze, cough // eval acute pulmonary process
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Pa and lateral views of the chest provided. There is stable cardiomegaly with vague opacity in the left lower lobe concerning for pneumonia. No large effusion or pneumothorax. No overt signs of edema or pulmonary vascular congestion. The imaged bony structures are intact.
<unk>m with cough // eval infiltrate
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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.
history: <unk>f with sob, dyspnea, cough // eval ? edema, infiltrate
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The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.
<unk>m with left sided chest pain with radiation to the left arm
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The lungs are clear. There is no effusion, pneumothorax or consolidation. Cardiomediastinal silhouette is within normal limits. Tortuosity of the descending thoracic aorta is noted. No acute osseous abnormalities identified.
<unk>f with fall, neck pain, l upper chest/clavicle pain // eval for acute fracture
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Cardiac silhouette size is normal. Dense atherosclerotic calcifications are noted at the aortic arch. The patient is status post cabg and coronary artery stenting. Pulmonary vasculature is normal. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormality is identified.
history: <unk>m with syncope on plavix //
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There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal contour is normal.
<unk>m with elevated lactate, evaluate for infectious process.
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The lungs are clear. There is no evidence of pneumonia, pneumothorax, or pleural effusion. Cardiac silhouette is normal in size.
<unk> year old woman with ruq abdominal pain, recent pneumonia // evaluate for acute proces
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Lungs are clear. There is no focal consolidation, effusion, or pneumothorax. Mediastinal and hilar contours are stable. Heart size is normal.
<unk> year old man with cirrhosis, <unk>, r./o infection // assess for any infiltrate
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Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. A patchy opacity in the left lower lobe is concerning for pneumonia in the appropriate clinical setting although atelectasis could also be considered, particularly noting its steaky character. The lungs appear otherwise clear. There is no pneumothorax, vascular congestion, or pleural effusion.
<unk>-year-old female with cough and shortness breath. question pneumonia.
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Frontal and lateral views of the chest demonstrate normal lung volumes. There is no pleural effusion or pneumothorax. Hilar and mediastinal silhouettes are unchanged. Moderate cardiomegaly is unchanged. There is mild pulmonary edema. Sternotomy wires are in place, the most superior of which is fractured. Partially imaged upper abdomen is unremarkable.
cough and fevers.
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Ap and lateral views of the chest are compared to previous exam from <unk>. Lower lung volumes seen on the current exam. Linear opacities at the left greater than right lung bases are most suggestive of atelectasis. However, given more confluent opacity in the lateral view underlying consolidation is also possible. Cardiomediastinal silhouette is stable given lower inspiratory effort. Osseous and soft tissue structures are unremarkable.
<unk>-year-old male with new onset of dizziness and altered mental status. question pneumonia.
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Frontal and lateral views of the chest were obtained. There are diffuse increased interstitial markings bilaterally, as also seen in prior study. However, on the lateral view they seem slightly more prominent compared to the prior study and i cannot exclude an acute-on-chronic process. Mild left base atelectasis/scarring is seen. No pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are stable.
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Persistent widening of right paratracheal stripe, consistent with known lymph node enlargement in this region on prior ct. Additional calcified lymph nodes are seen in the subcarinal region and and are seen to better detail on the recent ct scan. Heart size is normal. Within the lungs, note is again made of a discrete nodule in the right upper lobe measuring approximately <num> cm. Lungs are otherwise clear, and there are no pleural effusions or pneumothoraces.
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A right hemodialysis catheter ends in the atrium. Mild cardiomegaly is unchanged. A pigtail catheter is stable. The moderate right and small left pleural effusion are unchanged. Bibasilar atelectasis has slightly improved. There is no new consolidation or pneumothorax.
myasthenia crisis with prior hematoma. evaluate for change in hemothorax.
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No focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. Hilar contours are stable.
<unk> year old woman with nbnb emesis after coughing. // please r/o pna
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The cardiomediastinal is top normal. The hilar contours are within normal limits. The lung fields are clear. There is no pneumothorax, fracture or dislocation. Limited assessment of the abdomen is unremarkable. A density projecting over the humeral head appears to be a soft tissue calcification on radiograph <unk>.
history: <unk>f with night sweats, <num>lb weight loss // eval ? infiltrate, lung mass
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Frontal and lateral views of the chest. Heart size and cardiomediastinal contours are normal. There is lung hyperinflation without focal consolidation, pleural effusion, or pneumothorax.
<unk>-year-old female with shortness of breath.
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There is opacity within the right lower lobe concerning for pneumonia. There is slight downward migration of the right hilus given the resulting volume loss. No pleural effusion or pneumothorax. The cardiac and mediastinal contours are normal.
fevers and cough. evaluate for pneumonia.
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Heart size is normal. Cardiomediastinal silhouette and hilar contours are normal. Linear scarring is noted at the left lung base. Lungs are otherwise clear. Pleural surfaces are clear without effusion or pneumothorax.
dyspnea on exertion.
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As compared to the previous radiograph, the parenchymal opacity at the right lung base has minimally increased in density but decreased in extent. This suggests the presence of a retractile component or a fibrotic organization. No new parenchymal opacities. Unchanged staple lines after surgery and unchanged right paramediastinal post-surgical changes. Unchanged size of the cardiac silhouette. Unchanged minimal left basal atelectasis.
post-lung cancer, cop. evaluation.
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The lungs are well inflated and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax. No acute osseous abnormality is identified.
<num> hours of chest pressure, evaluate for acute cardiopulmonary process.
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As compared to the previous radiograph, there is substantial improvement with near total resolution of the pre-existing right basal opacity. However, the resolution is not yet complete. No evidence of newly appeared parenchymal changes. No reactive pleural effusions. Normal size of the cardiac silhouette without pulmonary edema.
history of cavitary right-sided pneumonia. evaluation of interval changes.
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Following recent bronchoscopy, there has been marked improved aeration of the left lung with residual collapse of the left lower lobe. There is no evidence of a post-procedural pneumothorax. Diffuse haziness of the left hemithorax could reflect a layering pleural effusion.
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The lung volumes are low. The mediastinal, cardiac and hilar contours appear unchanged. There is mild elevation of the right posterior diaphragm. Atelectasis has improved since the prior examination, and the lungs appear clear. There is no pleural effusion or pneumothorax. Surgical clips project about the undersurface of the medial left hemidiaphragm. Bony structures are unremarkable.
right shoulder and chest pain.
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Ap upright portable chest radiograph is obtained. There has been interval insertion of a right-sided chest tube with the tip pointing towards the right lung apex. There is minimal residual right apical pneumothorax. Subcutaneous emphysema at the right chest tube insertion site noted.
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Single portable view of the chest. Endotracheal tube is not seen within <num> cm from the carina and should be withdrawn for optimal positioning. Enteric tube passes below the field of view. There is dense left basilar opacity silhouetting left heart border and left hemidiaphragm. The left mid lung and right basilar opacities are also seen. Superiorly the lungs are clear. Cardiomediastinal silhouette difficult to assess for reasons stated above. Dense atherosclerotic calcifications are noted. Degenerative changes seen at the shoulders.
<unk>-year-old female status post intubation.
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Ap single view of the chest has been obtained with patient semi-upright position. Comparison is made with the next preceding similar study of <unk>. There is now a significant improvement of the previously existing general perivascular haze in the pulmonary circulation. Still congestive pattern on the bases with bilateral pleural effusions is present but no new discrete pulmonary parenchymal infiltrates of pneumonic character have developed. No pneumothorax in the apical area. Unchanged position of previously described left subclavian central venous line.
<unk>-year-old female patient with acute myelocytic leukemia, pulmonary edema secondary to atrial fibrillation.
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The tip of the enteric tube now projects over the left upper quadrant likely within the gastric body. Remaining findings are unchanged since <num> hour prior including the left hip basilar opacity concerning for aspiration/ atelectasis.
<unk> year old man with ng placed. evaluate ng tube placement.
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There is no consolidation, pleural effusion, or pneumothorax. Cardiomediastinal silhouette and hilar silhouettes are normal size. Right infusion port terminates in the upper svc. Left carotid artery stent and coronary artery stents are noted. There are old healed fractures of posterior left <num>, <num>, and <num> ribs.
<unk> year old woman with chest pain // eval for acute process
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No focal consolidation to suggest pneumonia is seen. No pneumothorax is identified. The lungs are hyperinflated. There is likely trace left pleural effusion though improved from the prior exam. Additional opacities at the left base are felt to likely represent residual atelectasis. There is mild cardiomegaly and tortuosity of the aorta. A previously seen left-sided picc has been removed. A dual-lead pacemaker is unchanged with leads in standard positions. Sternal cerclage wires are intact.
reported hypotension. bronchial breath sounds on the right. no cough.
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On today's radiograph, there is evidence of a small left apical pneumothorax. In addition, a subtle air-fluid level is seen in the posterior aspects of the left hemithorax. The extent of the left pleural effusion is unchanged. Mild decrease in extent of the left cervical and chest wall air collection. Atelectasis at the left lung bases persists. The right lung shows substantially improved ventilation. Unchanged size of the cardiac silhouette. At the time of dictation and observation, <time> a.m., on <unk>, the referring physician, <unk>. <unk> was paged for notification and the findings were discussed over the telephone <num> minute later.
questionable resolution of pneumothorax. evaluation of interval changes.
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No previous images. There is enlargement of the cardiac silhouette without evidence of vascular congestion, pleural effusion, or acute focal pneumonia. Port-a-cath tip extends to the mid to lower portion of the svc.
cough and rales at the left base.
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Left-sided port-a-cath terminates in the mid svc. Low lung volumes persist. There are seen small bilateral pleural effusions with overlying atelectasis. Mild central pulmonary vascular engorgement is seen. The cardiac and mediastinal silhouettes are stable.
history: <unk>m with dyspnea // r/o acute process
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Frontal and lateral views of the chest were obtained. Patient is rotated somewhat to the left. Patient is status post median sternotomy. Mitral annulus calcification is seen. No definite focal consolidation is seen. There is no pleural effusion, or evidence of pneumothorax. The cardiac silhouette is top normal. The aorta is calcified and tortuous. No overt pulmonary edema is seen. No displaced fracture is identified.
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A single ap radiograph of the chest was acquired. As before, the patient is status post right upper lobectomy for prior lung carcinoma. Right apical pleural thickening and loculated pleural effusion has decreased compared to <unk>. There is minimal bibasilar atelectasis. No focal consolidations are noted. The heart size is normal. The mediastinal contours are unchanged. There is no pneumothorax. There is evidence of prior right thoracotomy, as before.
metastatic lung cancer and shortness of breath. evaluate for pneumonia.
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Frontal and lateral radiographs of the chest were acquired. There is redemonstration of prior midline sternotomy and cabg as well as a prosthetic aortic valve. There has been interval removal of the previously seen left picc. Blunting of the left costophrenic angle is not significantly changed, likely secondary to scarring and a small pleural effusion. There is no focal consolidation. The heart size is upper limits of normal. Mitral annular calcifications are noted. There is no right pleural effusion. No pneumothorax is seen. The mediastinal contours are normal.
failure to thrive. assess for pneumonia.
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The cardiomediastinal contour is normal. There is no pleural effusion or pneumothorax. There is no focal lung consolidation.
<unk>-year-old woman with chest pain and thyrotoxicosis.
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Frontal and lateral views of the chest were obtained. Lungs are hyperinflated, suggesting chronic obstructive pulmonary disease. Thoracic kyphosis and compression deformity of mid thoracic vertebral body is also seen on the prior study. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. Previously seen small bilateral pleural effusions are no longer evident. The aorta is calcified and tortuous. The cardiac silhouette is top normal. There is diffuse osteopenia. Degenerative changes at the shoulder joints again seen.
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Icd biventricular pacing device is again demonstrated, with leads terminating in the right atrium, right ventricle and a third lead for biventricular pacing. Lead position is unchanged from the prior radiograph. Cardiomediastinal contours are normal. Lungs are hyperexpanded and grossly clear.
<unk> year old man with biv-icd with surgical site infection // is icd in place?
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Portable ap upright view of the chest provided demonstrates endotracheal tube tip residing <num> cm above the carina. The orogastric tube extends into the left upper quadrant. The lung volumes are low, without definite signs of focal consolidation or effusion/pneumothorax. The cardiomediastinal silhouette is normal. Relative prominence of the perihilar markings likely due to portable technique. Bony structures are intact.
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The heart size is mildly enlarged, similar compared to the prior study. There is mild pulmonary vascular congestion. Mediastinal and hilar contours are unchanged. No pleural effusion or pneumothorax is seen. No focal consolidation is identified. No acute osseous abnormalities demonstrated. Degenerative changes are seen involving both shoulders.
history: <unk>f with altered mental status
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The lungs are clear. No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The heart size is normal. Mediastinum and hila are within normal limits. No interval change.
<unk> year old woman with renal/pancreas transplant on csa/mmf, new leukocytosis and encephalopathy, concern for pna/aspiration. evaluate for pneumonia or aspiration.
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Right ij catheter tip projects over the expected region of the proximal right atrium, unchanged. Lung volumes remain low. Asymmetric appearance of the lungs has resolved, likely reflecting rotation on the prior exam and asymmetric edema. However, mild left lower lobe opacity persists, suggesting atelectasis. No pneumothorax. No large effusion.
<unk> year old woman with sepsis // eval for interval change
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In comparison with the study of <unk>, the vascular congestion seen on the prior study appears to have decreased. The hemidiaphragms are not well seen. This could be a technical artifact or reflect small pleural effusions with associated atelectatic change. Enlargement of the cardiac silhouette persists.
melanoma with brain mets and radiation, to assess for change.
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Low bilateral lung volumes. There are increased bibasilar opacities which likely reflect atelectasis. No pneumothorax identified. The size of the cardiac silhouette is enlarged but unchanged. Re- demonstrated is a thoracoabdominal aortic stent.
<unk> year old man with fever, decreased breath sounds at the r lower base // opacity
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As compared to the previous radiograph, the patient has made a bigger inspiratory effort. Borderline size of the cardiac silhouette. No pleural effusions. No focal parenchymal opacity suggesting pneumonia. No pulmonary edema. Normal hilar and mediastinal contours.
evaluation for pathology.
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The patient is status post median sternotomy and mitral valve replacement. Status post sternotomy. The cardiac silhouette continues to be enlarged. There is mild chf. No pleural effusion or pneumothorax is noted.
<unk>-year-old female with right leg swelling and dyspnea. please assess for deep vein thrombosis and for pneumonia.
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Lung volumes are normal. There is no pleural effusion, pneumothorax or focal airspace consolidation worrisome for pneumonia. There is elevation of left hemidiaphragm and blunting of the left lateral sulcus is likely a result of pleural scarring. Heart is normal size. Mediastinal and hilar contours are unremarkable.
altered mental status. evaluate for pneumonia.
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New from the prior examination is repositioning of the left-sided chest tube. The radiolucent portion of the tube, presumably representing a side hole, now projects over the left hemi thorax. No other significant change from the prior examination.
history: <unk>m with chest tube // ? placement of chest tube
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Slight increase in opacity above the posterior left hemidiaphragm on the lateral view may be artifactual given there appears to be external artifact coursing over the image of this location; however, an underlying consolidation is not excluded. No evidence of focal consolidation is seen elsewhere. Prominence of the right hilum, is increased since the prior chest radiographs from <unk>; however, similar compared to ct from <unk>, in this patient where underlying right hilar lymphadenopathy was seen on recent prior ct. No pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable.
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Following left thoracentesis, a left pleural effusion has nearly resolved, and there is no visible pneumothorax. Associated improving aeration at left lung base. Stable mild cardiomegaly accompanied by pulmonary vascular congestion. Worsening heterogeneous opacities in right mid and lower lung regions could reflect asymmetrical edema or infection. Interval slight repositioning of left picc, with unusual bend at its distal point in the right tracheobronchial angle suggests the possibility of extension into the azygos vein. This could be further assessed by lateral cxr.
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As compared to the previous radiograph, the swan-ganz catheter and the right-sided chest tube as well as the mediastinal drain has been removed. A right venous introduction sheath remains in place. There is no indication for the presence of a pneumothorax. Unchanged mild cardiomegaly with signs of mild fluid overload. Bilateral basal areas of atelectasis. No pneumonia.
status post aortic dissection, repair, evaluation for pneumothorax.
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The lungs are clear without focal consolidation, pleural effusion or pneumothorax. There is no pulmonary edema. The heart is normal in size, and the mediastinal contours are normal.
<unk>-year-old female with dyspnea, palpitations. please evaluate for infiltrate, effusion, edema.
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Cardiomegaly is stable. Small right and moderate left pleural effusions are stable. There is no pneumothorax. There is no pulmonary edema. Sternal wires are aligned.
<unk> year old woman s/p cabg // eval pleural effusion**please schedule asap in am for subsequent thoracentesis/tee - thanks!***
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Anterior cervical spine fixation hardware is partially imaged. The inspiratory lung volumes are appropriate. There is diffuse moderate pulmonary edema and small bilateral pleural effusions compatible with volume overload. No pneumothorax is detected. The cardiac silhouette is borderline enlarged, as before. The mediastinal contours are within normal limits. No acute osseous abnormality is detected.
history of end-stage renal disease, now with dyspnea, here to evaluate for pulmonary edema.
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Endotracheal tube is seen, terminating <num> cm above the level of the carina. Recommend withdrawal by approximately <num>-<num> cm for more optimal positioning. A nasogastric tube is seen coursing below the level of the diaphragm, inferior aspect not included on the image. There is left base retrocardiac opacity and subtle increased opacity projecting over the left lung which may be due to layering pleural effusion. Left base atelectasis or consolidation is not excluded. No evidence of pneumothorax is seen. The cardiac silhouette is top normal. The aorta is calcified. The bones are osteopenic. Degenerative changes are seen at the shoulder joints, partially imaged. There appears to be external artifact that overlies the right hemithorax. A left-sided picc terminates high in position, in the region of the left subclavian vein.
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In comparison with the study of <unk>, the endotracheal and nasogastric tubes have been removed. There is continued substantial enlargement of the cardiac silhouette with pulmonary edema. In the appropriate clinical setting, supervening pneumonia would have to be considered. The hemidiaphragms are more sharply seen. Pacer device remains in place with the leads in the right atrium and apex of the right ventricle.
copd with atelectasis.
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Compared to the prior study there is no significant interval change in the appearance of the lungs. There is a new dobbhoff catheter with tip in the stomach.
<unk> year old woman with dobhoff replaced // eval new dobhoff placement
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Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.
<unk> year old man with acute strokes
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Lung volumes are low. The lungs are clear without a focal consolidation, effusion, or pneumothorax. Moderate cardiomegaly is stable. Descending thoracic aorta remains mildly tortuous. No acute fractures are identified.
cough and wheezing.
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In comparison with study of <unk>, there is little change. With left chest tube in place, there is no definite pneumothorax. Elevation of the right hemidiaphragmatic contour persists with some atelectatic changes above it medially. No new parenchymal infiltrates.
pneumothorax.
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An ill-defined, large opacity in the left upper-mid lung is concerning for pneumonia. Larger and more dense opacity in the left lower lung is likely a combination of moderate effusion and atelectasis and/or consolidation. Right lung is clear. Pleural effusion if any is minimal on the right side.
<unk>-year-old man with evaluation for lung expansion/effusion.
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The cardiac, mediastinal and hilar contours appear unchanged. Lung volumes are low. There is no pleural effusion or pneumothorax. The lungs appear clear.
weakness.
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Frontal and lateral chest radiographs demonstrate a normal cardiomediastinal silhouette and well-aerated lungs which are clear. There is no focal consolidation, pleural effusion, or pneumothorax. The visualized upper abdomen is unremarkable.
chest pain.