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As compared to chest radiograph from <num> day prior, interval removal of endotracheal tube, swan-ganz catheter, mediastinal drains and chest tube. No visualized pneumothorax. Retrocardiac opacity is stable likely a combination of atelectasis and effusion. Pulmonary vascular congestion has improved. Moderate cardiomegaly.
<unk> year old woman with s/p avr, cabg, cts d/c'd // evaluate for pneumothorax
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Endotracheal tube terminates <num> cm above the carinal and a nasogastric tube is coiled in the proximal stomach with tip directed cephalad in the fundus. Lung volumes are low. Cardiac silhouette is partially obscured on the left but likely mildly enlarged. Widening of mediastinal and hilar contours could reflect vascular engorgement or lymph node enlargement. Asymmetrically distributed bilateral airspace opacities involve the left lung more than the right. In the right lung, consolidation is most prominent in the right upper lung above the minor fissure. These findings are superimposed upon a bilateral interstitial pattern.
<unk> year old man with chf pna ipf // eval for intrapulm process
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The heart is normal in size. The mediastinal and hilar contours appear within normal limits. There is a streaky opacity projecting over the left mid lung, probably in the lingula, which is suggestive of atelectasis, but which could potentially represent an early focus of pneumonia. There is no pleural effusion or pneumothorax. Small osteophytes are noted along the thoracic spine.
question septic emboli or pneumonia.
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Emphysematous changes are seen with biapical predominance. Calcified nodules project over the right lung suggestive of granulomas. The lungs are otherwise clear without consolidation or effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified.
<unk>f with brain mass // eval infiltrate, cardiomegaly
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Since prior, there has been interval removal a right sided picc line. The cardiomediastinal and hilar contours are within normal limits. There is bibasilar atelectasis which has decreased since prior. There is redemonstration of the <num> mm calcified granuloma within the right mid chest. No new focal consolidation, pleural effusion or pneumothorax. Surgical drain projects over the right upper quadrant.
cholangiocarcinoma, septic. please assess for pneumonia.
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Pa and lateral chest radiographs were provided. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is notable for a tortuous aorta. The bones are intact.
history of aml and neutropenia and shortness of breath.
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Ett tip ends approximately <num> cm from the carina, too high with the patient's chin flexed. Left subclavian line ends in the mid svc. Enteric tube crosses the midline and its tip is not seen. The stomach is nondistended. Minimal decrease in the layering right pleural effusion. Otherwise, no significant change. In the setting of a large right pleural effusion, the right lung cannot be fully assessed for consolidation. The heart size is normal. The left lung is clear without focal consolidation to suggest pneumonia. No pneumothorax or overt pulmonary edema.
<unk> year old man with ett, pneumonia // interval change?
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Following thoracentesis, there is a decrease in the degree of effusions bilaterally, though some of this is probably related to a more upright position of the patient. No convincing evidence of pneumothorax.
thoracentesis.
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There is elevation of the left hemidiaphragm, posterior eventration. Mild basilar atelectasis is seen without focal consolidation. No large pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable.
history: <unk>f with syncope // eval for pna
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Frontal and lateral radiographs of the chest show an opacification projecting over the left heart on the frontal radiograph and the posterior lung base on the corresponding lateral radiograph consistent with left lower lobar pneumonia. No pleural effusion or pneumothorax is present. The pulmonary vasculature is not engorged. The cardiac silhouette is normal in size. The mediastinal and hilar contours are within normal limits.
<unk>-year-old male with <num>-day history of cough, fever and coarse rales on physical exam, here to evaluate for left lower lobe pneumonia.
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As compared to the previous radiograph, there is no relevant change. Areas of increased radiodensity are seen projecting over the left lung apex, in particular at the level of the ventral part of the first left rib as well as the aortic arch. These areas have not increased in extent and severity as compared to the previous examination. In the interval, the lung volumes have increased, likely reflecting improved ventilation, with subsequent decrease in extent of a pre-existing right basal atelectasis and a small left retrocardiac atelectasis. No new parenchymal opacities. No pneumothorax.
status post vats, left upper lobe collapse.
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In comparison with the study of <unk>, there has been removal of fluid from the right pleural space with no evidence of post-procedure pneumothorax. Some residual effusion is seen. Minimal blunting of the left costophrenic angle is noted. No definite vascular congestion or acute focal pneumonia.
right thoracentesis.
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Compared to the prior exam, the et tube and swan-ganz catheter have been removed. Left-sided chest tube is again visualized. There is volume loss at both bases. An underlying infiltrate in either lower lobe cannot be excluded. There are small bilateral pleural effusions. Compared to the prior exam, the volume status in the lower lobes is worsened, as are the small effusions.
left-sided chest tube.
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The et tube ends <num> cm above the level of the carina. There is a right-sided pacemaker with associated right atrial and right ventricular leads. A right internal jugular venous catheter is seen, containing an additional pacer wire that ends over the region of the right ventricle. There is minimal bibasilar atelectasis. There is likely a small left pleural effusion. The heart size is normal. The mediastinal contours are normal. Aortic knob calcifications are seen. There is no pneumothorax.
evaluate tube placement.
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The et tube terminates in the standard position. The right internal jugular catheter still terminates in the right atrium. The ng tube terminates near the diaphragm and the side hole is clearly above the diaphragm. There is no change in cardiomegaly and bilateral pleural effusions.
cardiac arrest, currently intubated. evaluation of et tube placement
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Et tube terminates <num> cm above the carina. Esophageal stent is intact. Sternotomy wires are intact. Mediastinal surgical clips are again noted. There is pneumoperitoneum, which is probably explained by recent j-tube placement. There is increased opacity in the left lung, which could be due to increased pulmonary edema. Right lower lobe opacity is probably due to atelectasis and appears similar to <num>hr prior. Bilateral pleural effusions are small, larger on the right. There is no pneumothorax. Cardiac silhouette is borderline enlarged.
<unk> year old man s/p bronch and j tube placement // please assess for interval changes
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The left internal jugular catheter is unchanged. Calcified nodules in the right upper lobe are also unchanged in appearance. Lung volumes are slightly increased compared to the prior study, although the cardiac and mediastinal contours are unchanged, top normal. There is prominence of the pulmonary vasculature with increased interstitial markings. There are no pleural effusions. No pneumothorax is seen.
esrd on hd, presenting with chest pain and hypotension. evaluate for vascular congestion.
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Frontal and lateral chest radiographdemonstrates well expanded and clear lungs.no pleural effusion or pneumothorax. Heart size, mediastinal contour, and hila are unremarkable. Limited assessment of the upper abdomen is within normal limits. Limited assessment of the osseous structures demonstrates a mildly displaced lateral second right rib fracture. Cortical irregularity along the anterolateral right third rib may represent a subtle fracture.
assault <num> week prior. assess for obvious comminuted rib fracture or pneumothorax.
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Endotracheal tube terminates approximately <num> cm above the level of the carina. Enteric tube courses below the diaphragm, out of the field of view. There are low lung volumes. Bilateral perihilar opacities suggest mild pulmonary edema. Left base opacity may be due to pleural effusion and atelectasis, underlying aspiration not excluded. No pneumothorax is seen.
history: <unk>f intubated // tube placement
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Pa and lateral views of the chest were reviewed. Compared to the most recent study of <unk>, there has been complete resolution of left lower lobe pneumonia. A residual pleural-based opacity likely represents a granuloma or post-infectious scarring; othwerwise, the lungs are clear. The cardiac and mediastinal contours are normal.
followup of left lower lobe pneumonia diagnosed one month ago.
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Pa and lateral views of the chest. The lungs are clear of focal consolidation or effusion. Right chest wall port is seen with catheter tip in the right atrium. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality is detected.
<unk>-year-old female with history of pancreatic cancer with fever. question pneumonia.
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As compared to the previous radiograph, there is a newly appeared relatively extensive parenchymal opacity at the right lung base. The opacity is partly nodular and partly peribronchial, showing multiple air bronchograms. The reticular component of the opacity suggests interstitial involvement. In the appropriate clinical setting, the opacity is infectious in nature. No reactive right pleural effusion. The left lung is unchanged. Unchanged moderate cardiomegaly. The tracheostomy tube has been removed. At the time of dictation and observation, <time> a.m., <unk>, the referring physician, <unk>. <unk>, was paged for notification.
status post cabg, new oxygen requirement, neutropenia, evaluation.
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Lung volumes are low leading to crowding of the bronchovascular structures. The lungs are otherwise clear without focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The patient is status post midline sternotomy with multiple sternotomy wires midline and intact. The heart is normal in size.
<unk>m with cva // assess for pna
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Streaky horizontal opacity in the right lower lung is most consistent with atelectasis. Otherwise, no focal consolidation, effusion, edema, or pneumothorax. No evidence of mediastinal free air. No evidence of subdiaphragmatic free air. The heart is normal in size. The descending thoracic aorta is slightly tortuous or ectatic. No mediastinal widening. No acute osseous abnormality.
<unk>-year-old man presenting with <num> hrs severe midline abd pain, + peritonitic signs on exam. evaluate for free air.
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The right picc tip terminates at the superior cavoatrial junction. The lungs are clear with minimal atelectasis at the left base. The cardiomediastinal contour is normal. No pleural effusion or pneumothorax.
history: <unk>f with picc malfunction // eval picc line
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Left-sided pacemaker has leads in the right atrium and ventricle. There is no pneumothorax or pleural effusion. The lungs are clear. The patient had prior sternotomy for cabg and mitral valve repair. Bilateral rib fractures are healed with adjacent pleural thickening.
patient with new pacemaker. assess lead position.
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Endotracheal tube terminates <num> cm above the carina. Nasogastric tube courses into the stomach and out of view. Left subclavian catheter terminates in the mid svc. Despite low lung volumes the vascular congestiona nd bibasilar atelectasis appears slightly improved. The heart size is mildly enlarged with normal cardiomediastinal silhouette.
intubation, assess for interval change.
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The heart is mildly enlarged. There are streaky left basilar opacities suggesting atelectasis or scarring that appears similar to the prior examination. There is no pleural effusion or pneumothorax. The bones are demineralized. There are mild degenerative changes throughout the thoracic spine. Mild compression of a thoracolumbar vertebral body appears similar. The bones are demineralized.
weakness.
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Mild bibasilar opacities are likely atelectasis. There is no pneumothorax or pleural effusion. Unusual mediastinal contour suggestive of right sided aortic arch is unchanged. Cardiac silhouette is normal size.
history: <unk>f with chest pain // chest pain sob
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Pa and lateral views of the chest provided. Lung volumes are low limiting assessment. Allowing for this, 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>f with chest wall pain
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The heart size is normal. The mediastinal and hilar contours are within normal limits. The lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is identified. No acute osseous abnormalities are seen.
syncope.
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The lungs are clear without focal consolidation, pleural effusion or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal.
aml with respiratory symptoms.
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Pa and lateral chest radiographs demonstrate persistent right middle lobe atelectasis and otherwise hyperinflated lungs with flattening of the diaphragm bilaterally. No new focal consolidation is concerning for pneumonia. No pleural effusion or pneumothorax is identified. The cardiomediastinal and hilar contours are otherwise stable.
history: <unk>f w pmh copd, cad, presenting with sob
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In comparison with study of <unk>, the monitoring and support device has been removed except for a right ij sheath. There is a small right apical pneumothorax. There is increased opacification at the bases consistent with layering effusions and compressive atelectasis, more prominent on the right. Fullness of pulmonary vessels is consistent with some elevated pulmonary venous pressure, and there is increased prominence of the cardiac silhouette.
chest tube removal, to assess for pneumothorax.
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Left-sided pacemaker device is noted with leads terminating in the right atrium and right ventricle. Epicardial pacing leads are also in unchanged positions. The heart size is normal. Mediastinal and hilar contours are unremarkable. Lungs are clear and the pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.
chest pain.
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There has been interval placement of a pigtail right chest tube, projecting over the inferolateral right chest, with overlap of the pigtail with the distal catheter, raising potential concern for kink. Correlate clinically for drainage. There is slight decrease in overall size of the right pleural effusion with minimal residual aeration of the right upper lobe. No pneumothorax. Suture in the left lung again noted.
<unk> year old man with new rt effusion // ptx? residual fluid?
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In comparison with study of <unk>, the endotracheal tube has been removed. Severe enlargement of the cardiac silhouette and the main pulmonary artery again consistent with pulmonary hypertension. Mild bibasilar atelectatic changes are seen, without definite vascular congestion or pleural effusion.
extubation.
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As compared to the previous radiograph, the previously malpositioned left picc line is now correctly positioned. The lung volumes remain low. There is no overt pulmonary edema. Minimal retrocardiac atelectasis. Borderline size of the cardiac silhouette. No evidence of pneumothorax.
chronic heart failure, exacerbation, evaluation for fluid overload.
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Single frontal image of the chest was obtained. There is severe chest wall deformity and levoscoliosis again seen. No focal opacities are visualized in the lungs. There is no pneumothorax or pleural effusion seen. Cardiomediastinal silhouette appears unchanged.
<unk>-year-old female with osteogenesis imperfecta and now with new oxygen requirement.
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Right internal jugular central venous catheter tip terminates in the mid svc. No pneumothorax. Heart size is normal. Mediastinal contour is unremarkable. There is been interval development of perihilar haziness and vascular indistinctness compatible with mild interstitial pulmonary edema. No focal consolidation or large pleural effusion is identified. No acute osseous abnormalities seen.
<unk>m status post right ij placement, please eval placement
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No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is seen. Heart and mediastinal contours are normal. Lung nodules, largest in the left mid lung, are better evaluated with ct. Right-sided port-a-cath terminates in the low svc, unchanged. Lytic sternal metastasis is better seen on recent ct. No large thoracic spine lesion is detected.
<unk>-year-old female with metastatic breast cancer and chest pain.
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Right sided chest tube has been removed. Patient is status post median sternotomy and cabg. Cardiac silhouette size remains mildly enlarged. The aorta is diffusely calcified. Mild pulmonary vascular congestion is demonstrated along with a moderate size right pleural effusion, slightly increased in size in the interval. There is associated right basilar patchy opacity, likely compressive atelectasis. A trace left pleural effusion is also likely present. Calcified granulomas are noted bilaterally, as seen previously. No pneumothorax is demonstrated. There are no acute osseous abnormalities detected.
history: <unk>f with fall, progressive weakness.
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Single portable view of the chest compared to previous exam from <unk>. The lungs are clear. There is no visualized pneumothorax or effusion. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable.
<unk>-year-old female with stabbing chest pain radiating to the back and left arm.
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There is a small to moderate persistent left pleural effusion, smaller when compared to previous exam. Elsewhere, the lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. Anterior cervical fixation hardware is partially visualized as well as an ivc filter in the abdomen.
<unk>f with epigastric pain s/p endoscopy <num> days ago // upright ot eval for free air
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Pa and lateral views of the chest are made to previous exam from <unk>. The lungs are clear. Cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable.
<unk>-year-old male with ankle fracture, preop.
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As compared to the previous radiograph, there is a newly appeared moderate right pleural effusion. The known left pleural effusion has increased in extent. The lung volumes have overall decreased and signs indicative of pulmonary edema have increased in severity. The cervical and thoracolumbar vertebral stabilization devices are unchanged, as is the left picc line. At the time of observation and dictation, <unk>, on <unk>, the referring physician, <unk>. <unk> was paged for notification.
end-expiratory wheeze.
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Frontal and lateral radiographs of the chest were obtained. Heart size and mediastinal contours are unchanged with tortuosity of the thoracic aorta. Atherosclerotic calcification of the ascening aorta and aortic arch are noted. No focal consolidation, pleural effusion or pneumothorax is present.
likely cva, question pneumonia.
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Linear bibasilar atelectasis is seen without evidence of focal consolidation. There is no pleural effusion or pneumothorax. The heart is mildly enlarged with normal mediastinal contours.
<unk>-year-old woman with a history of renal transplantation and immunosuppression, presenting with fever, assess for pneumonia.
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Ill-defined opacities at the right lung base are nonspecific and may represent atelectasis. No pleural effusion or pneumothorax. Heart size and cardiomediastinal contours are normal.
history: <unk>m with altered ms*** warning *** multiple patients with same last name! // ? pna
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As compared to the previous radiograph, the parenchymal opacities have minimally increased in severity and extent. There also is blunting of the costophrenic sinuses, more evident on the left than on the right, probably caused by pleural effusions. The endotracheal tube projects with its tip <num> cm above the carina and is unchanged. Normal size of the cardiac silhouette. No pneumothorax.
mechanical ventilation, assessment for endotracheal tube position.
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As compared to the previous radiograph, the signs indicative of pulmonary edema have mildly increased. There are slightly increasing bilateral pleural effusions. Moderate cardiomegaly and tortuosity of the aortic contour persist.
chronic heart failure, evaluation for interval change.
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The patient is status post median sternotomy. The right internal jugular central venous catheter remains present, the tip projecting over the distal svc. Bilateral perihilar and lower lung zone patchy airspace opacities. Relatively unchanged left pleural effusion. No pneumothorax identified. The size of the cardiomediastinal silhouette is enlarged but unchanged.
<unk> year old woman with cabg // r/o inf, eff
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Lung volumes are low. Cardiomediastinal silhouette is difficult to assess in the setting of low lung volumes. No pneumothorax or pleural effusion. Partially imaged spinal hardware is noted. Degenerative changes of the thoracic spine are moderate with probable calcification anterior longitudinal ligament. Degenerative changes in sequelae of prior proximal humeral fracture only partially imaged on the right.
<unk>-year-old man presenting after a <unk> feet fall down embankment, mild full body soreness. evaluate for traumatic injury.
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Tip of endotracheal tube terminates about <num> cm above the carina. Widespread subcutaneous emphysema is present bilaterally, and reduces the sensitivity of portable chest radiographs for detecting pneumothoraces. With this limitation in mind, no definite pneumothorax is visualized. A hyperlucency within the imaged portion of the upper abdomen may represent free intraperitoneal air in the setting of recent hiatal hernia repair, but is not fully characterized on this semi-upright study. Within the chest, cardiomediastinal contours are normal. Patchy bibasilar atelectasis is present. In addition to the above described diffuse subcutaneous emphysema, there is apparent pneumomediastinum in the upper mediastinal region.
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The lungs are clear with no evidence of a consolidation, effusion or pneumothorax. Cardiac and mediastinal contours are normal. No acute fractures are identified. There are mild degenerative changes in the thoracic spine.
cough, fever, and chills.
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Frontal and lateral radiographs of the chest were acquired. As before, there are streaky left lower lung opacities, most likely atelectasis and/or scarring. A more nodular component in this region likely represents a pulmonary nodule, as seen on prior ct from <unk>. A small left pleural effusion is not significantly changed. There is no right pleural effusion. No pneumothorax is seen. The heart size is normal. The mediastinal contours are normal.
right arm weakness with history of lung cancer. please evaluate for right upper lung opacities, consistent with pancoast tumor.
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Pa and lateral views of the chest were provided. The heart remains mildly enlarged with a left ventricular configuration. Lung volumes are slightly low though there is no definite signs of pneumonia or pulmonary edema. No pleural effusion or pneumothorax is seen. No free air below the right hemidiaphragm. Clips are noted in the right upper quadrant. Bony structures appear intact.
<unk> year old female with headache, cough, chest pain.
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In comparison with the study of <unk>, there has been placement of a nasogastric tube that extends to the upper-to-mid portion of the stomach with the side hole distal to the esophagogastric junction. Otherwise, little change.
nasogastric tube placement.
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Moderate cardiomegaly is noted. There is no focal consolidation, large effusion or pneumothorax. No pulmonary edema or congestion. Mediastinal contour appears within normal limits with atherosclerotic calcification along the aortic knob. Bony structures appear intact.
<unk>m with cough and fever over the past <num> days
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One portable <unk> view of the chest. There are new small bilateral pleural effusions and fluid in the minor fissure. There is bibasilar atelectasis. There is mild increase in pulmonary venous pressure. There is no evidence of pneumonia. The heart is slightly enlarged compared to most recent study. Mediastinal contours are normal. Aortic knob calcifications are stable.
dyspnea and orthopnea, rule out heart failure.
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There is again seen a right-sided picc line whose distal tip projects over the upper svc. The cardiomediastinal silhouette is unchanged and normal in appearance. The bilateral hila are normal. There is stable appearance of minimal bibasilar atelectasis. There are no other focal lung consolidations. There is no pulmonary vascular congestion. There is no pneumothorax or effusion.
<unk> year old man with picc // assess picc placement
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As compared to the previous radiograph, there is no relevant change. Pre-existing sternal wires and the drain projecting over the sternum are in unchanged position. No evidence of postprocedural pneumothorax. Minimal atelectasis at the left lung base. Borderline size of the cardiac silhouette and noncharacteristic scars at the right lung base. No pleural effusions. No pulmonary edema. No pneumonia.
median sternotomy, evaluation for pneumothorax.
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Lung volumes are low. There is no pulmonary edema or consolidation. Right-sided port-a-cath ends either at cavoatrial junction or lower svc. There is no pleural effusion or pneumothorax. Mediastinal and cardiac contours are normal. There has been aposterior spinal fusion of the thoracolumbar spine.
patient with metastatic breast cancer, onset of productive cough, wheezing, rule out infiltrate or edema.
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Frontal and lateral views of the chest were obtained. Left-sided picc is again seen, terminating in the distal svc. There is a moderate-to-large right-sided pleural effusion with overlying atelectasis, underlying consolidation is not excluded. The left lung is essentially clear. The cardiac silhouette is enlarged, although the right aspect of the cardiac silhouette is difficult to assess. Aortic knob is calcified. There is mild pulmonary vascular congestion.
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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.
history: <unk>f with sob // ? pna
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Lung volumes are low. The heart is moderately enlarged. Increased retrocardiac opacity likely secondary to atelectasis. The left hemidiaphragm is partially obscured secondary to a small left pleural effusion. No focal consolidation or pulmonary edema. No pneumothorax.
history: <unk>m with history of cdiff on contact precautions, and esrd with peritoneal dialysis presents with ams // eval for acute head bleed and pna. contact precautions
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Within the limitations of technique, although the heart has a left ventricular configuration, it is probably normal in size. The aorta is mildly tortuous. There is a retrocardiac nodular density which is probably due to summation shadow of converging ribs and pulmonary markings; otherwise lung fields appear clear. There is no pleural effusion or pneumothorax.
recent pneumonia and ekg changes.
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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. Posterior cervical fusion hardware is partially visualized.
<unk>-year-old male with chest pain. evaluate chest pain, rule out pneumonia
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As compared to the previous radiograph, the position of the endotracheal tube and the course of the nasogastric tube are unchanged. Unchanged low lung volumes with bilateral basal areas of atelectasis, moderate cardiomegaly and mild pulmonary edema. No new parenchymal opacities. No evidence of pneumothorax.
assessment for interval change after intubation.
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Large consolidation involving the right lower lobe and right middle lobe, worrisome for pneumonia. While not in the reported history for this radiograph, upon further investigation, the patient has a history of right perihilar mass. Findings may represent combination of perihilar mass and pneumonia. There may be a small right pleural effusion. The left lung is grossly clear aside from minimal left base atelectasis. No pneumothorax is seen. The cardiac and mediastinal silhouettes are grossly similar, given some obscuration on the right due to opacity.
history: <unk>f with cough // acute process?
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The lungs are clear. The cardiac and mediastinal contours are normal. There are no pleural abnormalities. No fractures are identified.
status post assault with left chest pain. evaluate for fracture.
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Left chest tube is in unchanged position. Small bilateral pneumothoraces are smaller compared to <num> hr prior. Subcutaneous emphysema in the left chest wall and left supraclavicular regions is similar, but slightly decreased . . Minimal bibasilar atelectasis. No chf, consolidation, or gross effusion. Again noted is curvilinear calcification overlying the left ventricle, consistent with known calcified wide some of the left ventricular aneurysm, as seen on chest ct from <unk>.
<unk> year old man with left chest tube unclamped and placed back to sxn // eval for chnage in sq air and eval for left ptx
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Bilateral pleural effusions appears to have increased since prior. There is now mild pulmonary edema. Cardiac silhouette is enlarged but stable compared to prior. Left chest wall dual lead pacing device is again noted.
<unk>m with chf // pulmonary edema
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Cardiac silhouette size is mildly enlarged. The mediastinal and hilar contours are grossly unremarkable. The pulmonary vasculature is not engorged. No focal consolidation, pleural effusion or pneumothorax is present. Bilateral lateral pleural thickening is noted, potentially related to subpleural fat. Left anterior glenohumeral joint dislocation is noted.
history: <unk>m with fall, shoulder dislocation
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Ap single view of the chest has been obtained with patient in sitting semi-upright position. Comparison is made with the next preceding similar study of <unk>. Previously described left internal jugular approach wide-bore dialysis catheter remains in unchanged position terminating within the right atrium. Unchanged is also the position of the vp shunt. No pneumothorax has developed. Previously described bilateral basal densities persist and are indicative of pleural effusions, more marked on the right than the left. There is no evidence of new discrete pulmonary parenchymal infiltrates in comparison with the previous portable chest examination.
<unk>-year-old female patient with history of seizure has vp shunt, status post renal transplant on <unk>, now with febrile neutropenia, viral urinary tract infection and cmv viremia, now with repeat fever spike. evaluate for evidence of consolidation - aspiration.
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The distal tip of the et tube is not well delineated due to overlying sternal wires, but likely lies approximately <num> cm above the carina, just below the medial clavicular heads on this lordotic view. Ng tube tip extends beneath the diaphragm and overlies the upper stomach. If a side-port is present, it does not clearly extend beyond the ge junction. Heart is not enlarged. Sternotomy wires are noted. The aorta is calcified and slightly unfolded. No chf, focal infiltrate or effusion is identified. No pneumothorax detected.
history: <unk>m with sdh*** warning *** multiple patients with same last name! // acute prpocess . history provided for head ct also ordered today refers to sdh.
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Pa and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is stable. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.
<unk>f with syncope
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Left hemidiaphragm remains elevated from at least <unk>. Patient is status post right upper lung surgery and the resulting "neo-fissure" is again visualized. There is no pleural effusion, pneumothorax or focal airspace consolidation. Heart is normal size. The mediastinal and hilar structures are unremarkable.
history of granulomatous disease now presenting with decompensated liver disease undergoing transplant evaluation. evaluate for cardiopulmonary abnormalities.
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As compared to the previous radiograph, there is increased volume loss in the left upper lung, surrounding the known large left upper lobe mass. In the interval, areas of fibrosis have newly occurred, contributing to the volume loss and to a leftward mediastinal shift. In addition, there is a minimal increase in left upper lobe lung density, potentially associated with early pneumonia. Otherwise, the radiograph is unchanged. Borderline size of the cardiac silhouette without pulmonary edema. No pleural effusions, no abnormalities in the right lung, except for a known and stable linear fibrosis at the right lung apex. At the time of dictation, <unk>, <time> p.m., the referring physician, <unk>. <unk> was paged for notification.
stage iv lung cancer, progressive cough, evaluation for pneumonia.
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Right-sided central venous catheter terminates in the mid the low svc without evidence of pneumothorax. The proximal portion of the venous catheter appears possibly coiled upon itself, however, part of the catheter may be external to the patient, and may just be overlapping. There are relatively low lung volumes. No focal consolidation is seen. There is no large pleural effusion or pneumothorax. The cardiac silhouette is top-normal, likely accentuated by ap, portable technique. Mediastinal contours are unremarkable.
history: <unk>f with hypotension // eval for pulm edema / acute biliary pathology
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The lungs are hyperinflated but clear without focal consolidation, effusion, or edema. The cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications are noted at the aortic arch. No acute osseous abnormalities.
<unk>f with dyspnea // r/o acute process
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Lung volumes are low. The heart appears enlarged which may be secondary to low lung volumes.increased retrocardiac opacity likely secondary to atelectasis in the setting of low lung volumes. No pleural effusion or pneumothorax is seen. The mediastinal silhouette is unremarkable.
history: <unk>m with shortness of breath // shortnes sof breath
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As on the prior study, there are very low lung volumes. Retrocardiac opacity obscuring the left hemidiaphragm is constant, concerning for infection or sequelae of aspiration in the appropriate clinical setting. Streaky opacities at the right lung base are unchanged and may represent atelectasis. There are bilateral pleural effusions which appear unchanged. There is no pulmonary edema. There is no pneumothorax.
<unk>f with sob, on bipap with pneumonia/bl pleural eff, evaluate for change in effusions.
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Borderline heart size, similar. Mildly increased pulmonary vascularity, more prominent. Segmental elevation left hemidiaphragm. No effusion. No pneumothorax. Tortuous calcified aorta. Minimal basilar atelectasis. Probable scarring right costophrenic angle.
<unk> year old woman with stroke // rule out pna
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<num> views were obtained of the chest. The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The heart and mediastinal contours are unremarkable.
increasing confusion and dizziness with increase in seizures. assess for pneumonia.
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A moderate right pneumothorax with associated without mediastinal shift is seen. Right axillary subcutaneous air is also noted. Right lower lung hazy opacity which could represent complicated fluid on this portable film. Cardiomediastinal silhouette is otherwise unremarkable. A right picc line is seen terminating in the upper svc.
<unk> year old man with desat // interval change, fluid overload interval change, fluid overload
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Portable single frontal chest radiograph was obtained. Multiple left-sided chest tubes have been removed. There is a tiny left apical pneumothorax. Persistent left upper and lower lung opacities are unchanged with basilar atelectasis. The right lung is essentially clear. The cardiomediastinal silhouette and hilar contours are stable. Sclerotic osseous metastases are extensive.
patient status post chest tube removal, followup.
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The patient is rotated to the right. There is relative elevation of the left hemidiaphragm, uncertain chronicity without prior. Streaky left basilar opacities suggestive of atelectasis. There is no effusion, pneumothorax or overt pulmonary edema. Cardiac silhouette is difficult to assess given rotation but is grossly unremarkable. There is tortuosity and dense atherosclerotic calcification of the thoracic aorta which appears also moderately enlarged at its proximal descending portion measuring <num> cm. No acute osseous abnormalities
<unk>m with ams // ?pna
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There is a right pectoral port-a-cath with its tip terminating at the cavoatrial junction. Bilateral surgical clips reflect prior breast surgery. Lungs are clear of focal consolidation, pleural effusion or pneumothorax. The heart is normal in size. There is no pulmonary edema.
<unk>-year-old female with dyspnea. evaluate for infiltrate.
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In comparison with the study of <unk>, there is little change and no evidence of acute cardiopulmonary disease. Tortuosity of the aorta without vascular congestion or pleural effusion or cardiomegaly. Specifically, no evidence of acute pneumonia.
cough, to assess for pneumonia.
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The heart size is normal. The aorta is diffusely calcified. Mediastinal and hilar contours are normal. Lungs are hyperinflated. Linear opacities in the lung bases either reflect scarring or atelectasis. No large pleural effusion or pneumothorax is identified though the costophrenic angles are not completely encompassed on the field of view. There are no acute osseous abnormalities.
bowel perforation, preoperative exam.
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Moderate to severe cardiomegaly is unchanged. There is mild interstitial pulmonary edema, slightly improved compared to the most recent chest radiograph. Aorta is tortuous and calcified at the aortic knob. Mediastinal and hilar contours are otherwise unchanged. No focal consolidation, large pleural effusion or pneumothorax is present. Mild degenerative changes are noted in the thoracic spine. An electronic device projects over the left chest wall.
history: <unk>m with left chest pain, leg swelling
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Cardiac pacemaker. Mildly improved right basilar opacity. Decreased interstitial markings lower lungs, particularly on the left. There is tiny right pleural effusion or thickening, similar. Mildly increased heart size, pulmonary vascularity, similar. Mitral annular calcifications. There are no rib fractures.
<unk> year old woman with frequent falls presents s/p fall ?rib fx and pulm contusion now with increasing somnolence // consolidation, contusion, fx?
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Right picc has been repositioned, with tip now terminating at expected location of the cavoatrial junction. Previously reported pulmonary edema has improved. There remains enlargement of the cardiac silhouette, retrocardiac opacification and bilateral pleural effusions, left greater than right.
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Left chest wall pacer leads are in standard position in the right atrium, right ventricle and through the coronary sinus. Median sternotomy wires appear intact. Bibasilar predominent interstitial opacities likely reflect moderate interstitial pulmonary edema. Heart size is mildly enlarged. There is worsening atelectasis at the left base. There is no large pleural effusion or pneumothorax. The aortic arch is calcified.
shortness of breath and tachypnea. evaluate for acute process.
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Single portable semi-upright frontal chest radiograph demonstrates hypoinflated lungs with a small sized right pneumothorax, which has increased from ct performed earlier that day. No flattening of the hemidiaphragm. The heart is mildly shifted leftwards. No left pneumothorax. Bibasilar atelectasis is noted. Scattered bilateral heterogeneous opacities most prominent within the lung apices likely represents contusions or mild pulmonary fibrosis as seen on ct chest. Mild cardiomegaly noted. Mediastinal contour and hila are otherwise unremarkable. No pleural effusion. Limited assessment of the osseous structures are notable for a minimally displaced right c<num> and nondisplaced c<num> rib fractures. Degenerative changes throughout the thoracolumbar spine. Visualized upper abdomen is within normal limits.
<unk> year old man s/p fall with traumatic pneumothorax. assess for pneumothorax.
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There are relatively low lung volumes with secondary crowding of the bronchovascular markings. There is no confluent consolidation, effusion or pneumothorax. The cardiac silhouette is enlarged similar to prior and also partially accentuated by low lung volumes. No acute osseous abnormalities.
<unk>m with sob and orthopnea, pls eval for effusion // history: <unk>m with sob and orthopnea, pls eval for effusion
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Small bilateral effusions with probable compressive lower lobe atelectasis noted. No pneumothorax. Cardiomediastinal silhouette appears mildly prominent, likely technique related. Bony structures are intact.
<unk>m with tachycardia, reported pneumonia // pneumonia, fluid overload
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Multifocal opacities involving bilateral lung bases and right upper lung are noted. Left lung base opacity appears increased compared to <unk>. No pneumothorax or large pleural effusion is identified. Mildly enlarged cardiac silhouette is unchanged. Et tube terminates <num> cm above the carina. Transesophageal tube terminates in the stomach. Right internal jugular venous catheter terminates in upper svc.
<unk> year old man with ?pcp pneumonia, persistent need for intubation // evaluate pt with resp distress, requiring intubation still
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The lungs are well expanded. There are no focal opacities. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax.
<unk>-year-old female with cough, weakness, and rales in the right base. evaluate for evidence of pneumonia.