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The endotracheal tube is slightly high, approximately <num> cm from the carina. An enteric tube courses below the diaphragm with the tip at the stomach. The sideport is at the gastroesophageal junction. There is mild pulmonary vasculature congestion without overt pulmonary edema. There is no focal opacity, pleural effusion, or pneumothorax. The mediastinal contours are normal. The heart size is mildly enlarged, which may be related to positioning.
status post intubation. evaluate tube placement.
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Pa and lateral chest views were obtained with patient in upright position. The moderately enlarged heart appears unchanged. Thoracic aorta as before with marked extensive wall calcifications. The previously observed right-sided pleural effusion that blunts the lateral and posterior pleural sinus has again increased and reaches now to the mid portion of the right-sided lateral chest wall. On the lateral wall, the increased densities are located most posteriorly and have also increased when comparison is made between the lateral views. No new acute pulmonary infiltrates can be identified and there is no pneumothorax in the apical area. The patient has undergone a lymphangiogram on the preceding day, which showed some filling of lymphatic channels from the left leg up to the retroperitoneal structures and periaortic location. At no point was communication with the thoracic duct established. Thus, it is not surprising that any pulmonary arterial embolization with contrast particles cannot be identified on the plain chest examination. It is possible, however, that lymphangiographic material has entered in the right lower pleural and pulmonary parenchymal territory as the ct examination of <unk> suggested.
<unk>-year-old female patient with chylothorax, status post lymphangiogram, still with oxygen requirement, evaluate for interval change of effusion or contrast in the lungs.
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In comparison with the study of <unk>, there is little overall change in the cardiomegaly with vascular congestion and bilateral layering pleural effusions with compressive atelectasis at the bases. Monitoring and support devices are unchanged.
mi with intubation.
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Single upright portable chest radiograph demonstrates low lung volumes. Heart size is exaggerated by low lung volumes and technique. There is no focal opacity present. No evidence of pulmonary edema. Streaky opacities at the lung bases reflect atelectasis. There is no large pleural effusion or pneumothorax. No air under the right hemidiaphragm is present.
<unk>m with <num>d severe abd pain with remote hx ex lap // any free air
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There is no evidence of new consolidation. Minimal interstitial lung markings are unchanged since <unk>. On previous abdominal ct, there was possibly minimal reticulation in subpleural area. Cardiac contour is mildly enlarged. There is no pleural effusion or pneumothorax.
please evaluate for right-sided pneumonia.
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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.
lower extremity weakness, chest pain, and nausea.
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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.
history: <unk>f with exertional chest pain and shortness of breath
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Mild bibasilar atelectasis is noted. No large focal consolidation is identified. There is no pneumothorax, pleural effusion, or pulmonary edema. The cardiomediastinal silhouette, pleural surfaces, and hilar contours are grossly normal. Pectus excavatum is unchanged. The known metastatic pulmonary lesions are better assessed on the recent ct chest with contrast from <unk>.
<unk>m with history of bladder cancer status post resection and history of pulmonary metastasis, now with hemoptysis
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The lungs are well expanded and clear. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is unremarkable.
history: <unk>f with chest pain and mild sob // ?acute cardiopulmonary process
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Bilateral lower lobe pneumonia, right greater than left, is stable since <unk> but improved since <unk>. The cardiac silhouette remains top-normal. No pneumothorax or pulmonary edema. The endotracheal to tip is seen <num> cm above the carina. Right internal jugular central line placement is unchanged and transesophageal drainage tube is seen over the stomach and continues had a few.
<unk> year old man with heart transplant, with respiratory failure secondary to ards, adenovirus pneumonia, and aspergillus infection. // evaluate for interval change.
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The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The chest is hyperinflated. There is no pleural effusion or pneumothorax. The lungs appear clear. Bony structures are unremarkable.
productive cough.
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The lungs are normally expanded and clear. The heart is top normal. The mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax.
dyspnea, chest pain and epigastric pain. evaluate for infiltrate.
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The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified, hypertrophic changes are noted in the spine. Gastric band identified in the left upper quadrant.
<unk>f with syncope // eval for infiltrate
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As compared to the previous radiograph, there is no relevant change. No pleural effusion. Minimal fluid marking of the minor fissure on the right. Normal size of the cardiac silhouette. No overt pulmonary edema. Unchanged mildly enlarged left hilus, caused by a mildly enlarged left pulmonary artery. No pneumothorax.
evaluation for effusion.
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There is a small right and moderate left pleural pleural effusion along with compressive left basal atelectasis. There is stable mild enlargement of the cardiac silhouette. Mild interstitial edema may be present. No pneumothorax.
<unk>f with dyspnea // pulm edema? effusion?
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Cardiac silhouette size is normal and unchanged. The mediastinal contours are similar. Superior retraction of the hila with architectural distortion, volume loss and coarse interstitial opacities with bronchiectasis and scarring in the upper lobes appear grossly unchanged. Additional coarse interstitial opacities are noted within both mid and lower lung fields with ring shadows, likely reflective of airway wall thickening, bronchiectasis and small airways disease. Blunting of the costophrenic angles bilaterally is compatible with small pleural effusions. There is likely mild pulmonary vascular congestion. No pneumothorax is present. There are no acute osseous abnormalities.
history: <unk>f with history of bronchiectasis and atrial flutter presents with shortness of breath and atrial flutter
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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>f with dm, htn, hld p/w cp <num>x in past month and sob. // eval for infiltrate, vascular congestion, acute process.
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Frontal and lateral views of the chest. No prior. The lungs are clear. There is no effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures are unremarkable.
<unk>-year-old male with pain with deep breath and shortness of breath.
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The lungs are well-expanded and clear. The cardiomediastinal and hilar contours are unremarkable. The heart is not enlarged. There is no pneumothorax, pleural effusion, or consolidation. No acute displaced rib fractures are identified.
<unk>f with chest pain
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Comparison is made to the previous radiographs from <unk>. There is a dual-lead left-sided pacemaker with intact lead tips. Heart size is upper limits of normal, but is stable. Lungs are grossly clear without focal consolidation, pleural effusions or signs for overt pulmonary edema. No pneumothoraces are seen.
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The lungs are clear.the cardiac, hilar and mediastinal contours are normal.no pleural abnormality is seen.
history: <unk>f with fever, cough. evaluate for pneumonia
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Tip of nasogastric tube terminates within the proximal stomach, but side port is not well visualized and could potentially be proximal to the ge junction. Right picc terminates within the region of the cavoatrial junction. Cardiac silhouette remains enlarged, but pulmonary edema has nearly resolved and bilateral retrocardiac opacities are also slightly better. These correspond to dependent airspace opacities on prior ct of <unk> and could potentially represent an aspiration pneumonia in the appropriate clinical setting. Right pleural effusion has apparently resolved, and small left pleural effusion is unchanged. Finally, note is made of right upper lobe partial atelectasis with ill-defined right upper lobe opacity accompanied by marked elevation of the right minor fissure.
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Right-sided port-a-cath tip terminates at the cavoatrial junction, unchanged. The heart size is normal. The mediastinal and hilar contours are unremarkable. The lungs are clear. No pleural effusion, focal consolidation, or pneumothorax is present. Eventration of right hemidiaphragm is stable. There are no acute osseous abnormalities. Cholecystectomy clips are noted in the right upper quadrant of the abdomen.
<num> months of progressive cough.
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Lungs are hyperinflated but clear. The cardiomediastinal silhouette is within normal limits. No focal osseous abnormality identified
<unk>m with pituitary macroadenoma p/w ams // ?pna, pulm edema
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In comparison with the study of <unk>, allowing for some degree of obliquity of the patient, there is no definite change. Hyperexpansion of the lungs and enlargement of the cardiac silhouette persists. No vascular congestion or acute focal pneumonia. There may be mild retrocardiac atelectatic changes.
copd exacerbation.
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A right chest wall port-a-cath ends in the low svc. There is no pneumothorax or pleural effusion. Cardiomediastinal silhouette is normal. There is no focal lung consolidation.
<unk>-year-old woman with metastatic gastric cancer and vomiting, evaluate for pneumonia
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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 male with cough and chest pain.
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Lines and tubes: newly placed right-sided picc extends into the right internal jugular vein and needs to be repositioned. Lungs: well inflated and clear. Pleura: there is no pleural effusion or pneumothorax. Right costophrenic angle has not been included on this radiograph. Mediastinum: there is no cardiomegaly. Mediastinal silhouette is within normal limits. Stable aortic knob calcification. Bony thorax: unchanged compared to the prior exam.
<unk> year old man with malpositionedc picc, s/p power flush // assess for change in position
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A pleural catheter is again seen in the left lung base, with interval decrease in pleural fluid, now trace. The lungs are clear and the heart size and mediastinal contours are stable. Right chest wall port catheter tip terminates in the low svc. Lucency at the left apex is increased but there is no clear pleural line. Attention on follow up is recommended.
<unk> year old man with pleurx // pleurx f/u
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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 are unremarkable.
bilateral lower extremity edema and shortness of breath. history of diabetes mellitus and hypertension.
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Pa and lateral views of the chest. Left-sided pacemaker/defibrillator is unchanged in position. Median sternotomy wires and mediastinal clips are again seen. There is no focal consolidation, pleural effusion or pneumothorax. The heart has been mildly enlarged and unchanged.
chest pain and elevated troponin.
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There are stable low lung volumes but no pleural effusion and interval improvement in pulmonary edema. There is stable cardiomegaly and mediastinum. Chest tube and endotracheal tube has been removed; no pneumothorax is seen. Fusion rods are again observed without obvious hardware complications. There is persistent left lower lobe atelectasis.
<unk>-year-old male status post removal of chest tube.
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Low lung volumes cause bronchovascular crowding. There is no focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The cardiomediastinal silhouette is stable. The osseous structures and upper abdomen are unremarkable.
<unk>m with chest pain, evaluate for acute process.
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A left-sided pacemaker and multiple leads are seen and are in appropriate position. The patient is status post median sternotomy and cabg. The heart is enlarged. There is a small to moderate right pleural effusion, which is possibly loculated. Opacity in the right lower lobe could represent consolidation due to pneumonia. There is no evidence of pneumothorax. There is no evidence of pulmonary edema.
<unk>m with doe and cough // eval edema, pna
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Ap upright and lateral views of the chest are provided. The lungs are hyperinflated with midline sternotomy wires and mediastinal clips. There is a stent projecting in the upper abdomen. There is likely a tiny left pleural effusion. No signs of pneumonia or chf. Cardiomediastinal silhouette is stable. Bony structures are intact.
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Portable semi-upright radiograph of the chest demonstrates worsening, bilateral, confluent airspace opacities with relative sparing of the extreme lung periphery. Peripheral septal lines are not appreciably changed. The cardiac silhouette is stable in size. A small left pleural effusion and possible right pleural effusion are noted. There is no pneumothorax.
<unk> year old man with recent hypoxemic resp failure secondary to multifocal pna, improved, now with worsening hypoxia // interval change, r/o pna
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Right internal jugular central venous catheter terminates in the lower superior vena cava, with no evidence of pneumothorax. Feeding tube terminates below the diaphragm. Persistent cardiomegaly, accompanied by pulmonary vascular congestion and minimal interstitial edema as well as small left and small-to-moderate right pleural effusion, the latter associated with worsening atelectasis at the right base.
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Swan-ganz catheter is in appropriate position, and <num> left chest tube have been removed. Median sternotomy wires are intact. Lung volumes continue to be low with moderate bilateral pleural effusions and associated atelectasis. No pneumothorax following chest tube removal.
<unk>-year-old man status post cabg and aortic valve replacement. evaluate for pneumothorax.
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In comparison with the study of earlier in this date, there is again enlargement of the cardiac silhouette with pulmonary edema and bilateral pleural effusions with compressive basilar atelectasis. In the appropriate clinical setting, the possibility of supervening pneumonia would have to be considered. Dual-channel pacer device remains in good position.
chf.
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The cardiac, mediastinal and hilar contours appear unchanged since at least the prior radiographs. There is no definite pleural effusion or pneumothorax. Lung volumes are low. An interstitial abnormality appears increased since the prior ct, and in particular, there is prominent posterior basilar opacity in the left lower lobe in the retrocardiac region. Radiographs are more difficult to compare directly to the recent prior ct although the distribution of the background interstitial abnormality appears fairly similar.
chest pain, cough, and non-specific interstitial pneumonitis.
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As compared to the previous radiograph, the patient has undergone a left pleural drainage. There is a posterior pneumothorax on the left, with a small amount of remaining left pleural effusion. The pneumothorax is not visible on the frontal image, as it has no apical component. The right pleural effusion is unchanged. Unchanged appearance of the ventilated lung parenchyma.
followup after pleural drainage.
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As compared to the previous image, the patient has been extubated and the nasogastric tube has been removed. As expected, the lung volumes have decreased, with minimal bilateral small pleural effusions. Mild-to-moderate areas of atelectasis at the lung bases. Mild fluid overload persists, but the extent and severity is less than on the previous images. The left internal jugular vein catheter is in unchanged position.
copd, respiratory failure, evaluation.
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As compared to the previous radiograph, there is no relevant change. Known right cavitary lesion. Known diffuse multifocal opacities, reflecting multifocal pneumonia. The monitoring and support devices are all unchanged. Elevation of the right hemidiaphragm persists. Unchanged appearance of the cardiac silhouette. No large pleural effusions.
cavitary lung lesion, multifocal pneumonia, evaluation for interval change.
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The heart size is moderately enlarged. The aorta is tortuous. Small to moderate-sized hiatal hernia appears to be present. The pulmonary vascularity is not engorged. Linear opacity within the left lower lobe is likely subsegmental atelectasis. No focal consolidation, pleural effusion or pneumothorax is identified. No acute osseous abnormalities are present.
chest pain after motor vehicle collision.
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The cardiomediastinal and hilar contours are at the upper limits of normal. The lungs are clear of consolidation. There is no pleural effusion or pneumothorax.
<unk>-year-old female with new hypoglycemia.
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Pa and lateral views of the chest were obtained. The heart is normal size and cardiomediastinal silhouette is unremarkable. Lungs are well expanded and clear. No pleural effusion or pneumothorax.
<unk>-year-old man, iv drug abuse, fevers and shortness of breath.
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Lung volumes are low. Patchy and linear opacities in the bases probably reflect atelectasis, but pneumonia is also possible and followup pa and lateral radiographs may be helpful for more complete evaluation when the patient's condition allows. Heart size, mediastinal and hilar contours are normal. Tip of vascular catheter terminates in the lower superior vena cava just above the junction with the right atrium.
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The cardiomediastinal and hilar contours are within normal limits. The heart is mildly enlarged. There is calcification of the aortic knob and the aorta is mildly tortuous. The lungs are clear without focal consolidation, pleural effusion or pneumothorax. Severe compression deformities of multiple thoracic vertebral bodies are again demonstrated and not significantly increased from <unk>.
<unk>f with recent fall // evaluate for pneumonia, rib fracture
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Lung volumes are lower compared to <unk>, with resulting exaggeration of bronchovascular markings. A component of pulmonary vascular congestion cannot be excluded. No focal consolidation concerning for pneumonia. There is no pleural effusion for pneumothorax. Heart size is top-normal. No acute osseous abnormalities.
history: <unk>m with cough // acute process?
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A bedside ap radiograph of the chest demonstrates marked worsening of the dense airspace consolidation affecting the right upper and middle lobes and the left upper lobe. There is no marked change in the size of the cardiac silhouette or the mediastinum, which does feature persistent vascular engorgement. There is no pneumothorax or pleural effusion, and the pulmonary vascularity is normal. A right-sided picc terminates in the mid svc.
patient with aml, on induction chemotherapy complicated by pneumonia, now presenting with tachypnea and hypoxia. evaluate for interval change in pneumonia or signs of congestive heart failure.
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As compared to the previous image, the extent of the bilateral pneumothoraces has slightly decreased. The pneumothoraces are millimetric in <unk> and small. There is no evidence of tension. The previously misplaced picc line is now in correct position, with the tip projecting over the lower svc. An area of atelectasis at the left lung base has minimally increased in extent. Right lower lung atelectasis, combined to some pleural effusion, is constant in appearance. Moderate cardiomegaly persists. No new parenchymal opacity suggesting pneumonia.
status post aortic valve repair, assessment for pleural effusions or pneumothorax.
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Left ij dialysis catheter terminates in the right atrium. There is worsening confluent right middle lobe opacification since the prior chest radiograph at <time>. The left lung is clear. Heart size is stable. The mediastinal and hilar contours are stable. The pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.
<unk> year old man with esrd on dialysis now with hypertension and getting urgent dialysis // r/o pulmonary edema
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Compared with <unk>, the et tube and ng tube have been removed. A left subclavian line tip overlies the distal svc. Mild prominence of the cardiac silhouette is probably is unchanged, allowing for differences in positioning and technique. There is upper zone redistribution and mild vascular plethora, without overt chf. Minimal atelectasis at both bases again noted. No frank consolidation identified. Minimal blunting of the right costophrenic angle is also similar to the prior film. Small left pleural effusion no longer seen. There are bilateral spinal fixation rods. There are fractures of the least to right chest wall ribs laterally, also unchanged. One appears healed, the other could be acute or subacute. An old healed right mid clavicular fracture is again noted.
<unk> year old man with cough // pna?
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Frontal and lateral views of the chest. The lungs are clear of focal consolidation, effusion or pulmonary vascular congestion. Cardiomediastinal silhouette is within normal limits. Median sternotomy wires are noted. No acute osseous abnormality is identified.
<unk>-year-old female with cough.
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Small right and moderate left pleural effusions, minimally fissural, have increased since <unk>. Left pic catheter has been removed. Lungs are clear except for bibasilar atelectasis, moderately severe on the left. Aorta is tortuous. Heart size is difficult to assess due to adjacent opacities, which may be mildly enlarged. There is no pneumothorax. Previous free subdiaphragmatic gas has resolved; <unk> chest ct shows gas in the gallbladder and biliary drains.
the patient with chest and abdominal pain.
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A <num> cm, geographic, soft tissue opacity projecting over the right mid lung on the frontal view is new since <unk>. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. A tortuous aorta is again noted. The right pulmonary artery is enlarged likely secondary to pulmonary hypertension. Persistent elevation of the right hemidiaphragm consistent with severe eventration. Multiple chronic anterior compression deformities of the mid thoracic spine result in moderate kyphosis.
<unk> year old man with sob // chf? right diaphragm?
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Ap portable upright view of the chest. Overlying ekg leads are present. Lung volumes are low. Allowing for limitations, the lungs are clear. No signs of pneumonia or edema. No large effusion or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact.
<unk>f with dyspnea, cough
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Heart size is normal. The aorta is mildly tortuous. The mediastinal and hilar contours are unchanged. Pulmonary vasculature is normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is detected. Mild degenerative changes are seen in the thoracic spine.
history: <unk>f with productive cough, shortness of breath
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Pa and lateral views of the chest show slightly smaller lung volumes than seen on the prior study from <unk>. Linear perihilar atelectasis noted in the right upper lobe with no consolidation seen suggesting pneumonia. Heart and mediastinal structures and bony structures show no significant interval change.
<unk>-year-old man with leukocytosis. question pneumonia.
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Lungs are clear. There is no pulmonary edema or lung consolidation. Cardiac contour is mildly enlarged. There is no pleural effusion or pneumothorax.
copd, pe on coumadin, pulmonary hypertension, shortness of breath.
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As compared to previous radiograph, there is no relevant change. Unchanged right picc line. Unchanged normal size of the cardiac silhouette. Unchanged moderate elevation of the left hemidiaphragm. No pathologic pulmonary parenchymal process.
eosinophilic esophagitis. evaluation.
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As compared to the previous radiograph, there is no relevant change. No evidence of pneumonia, no pleural effusions, no pulmonary edema. Borderline size of the cardiac silhouette, normal hilar and mediastinal contours.
hiv, cd<num> count of <num>, evaluation for infection.
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The lungs are well inflated and clear. No pleural effusion or pneumothorax. Mild cardiomegaly is noted. Mediastinal contour and hila are unremarkable. Limited assessment of the osseous structures are notable for mild multilevel degenerative changes of the thoracic spine with anterior osteophytes, endplate sclerosis and disc space narrowing.
<unk>f w/ cp after falling directly onto her chest. one episode vomiting.
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Poor positioning of the head obscures the right upper lung field. Heart size is top-normal. The mediastinal contours are unremarkable. A right pleural effusion is significantly increased in size compared to the prior exam. Lung volumes are improved with bibasilar atelectasis. The right hemidiaphragm is markedly elevated. Ett appears low, terminating near the level of the carina, but the head is also down, which causes caudal migration of ett. An enteric tube is noted with tip terminating in the stomach. A left axillary pacemaker is noted, but the pacemaker lead tip is not definitely visualized.
<unk> year old man with trauma, possible aspiration before intubated // please eval interval change
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There are small bilateral effusions. There is also a retrocardiac opacity silhouetting the descending thoracic aorta and medial hemidiaphragm. Elsewhere, the lungs are clear. Cardiomegaly is similar in degree compared to prior. Atherosclerotic calcifications noted in the aorta with tortuosity of its descending portion. Hypertrophic changes noted in the spine.
<unk> year old woman with cough for <num> week, rhonchi on exam, also missed dialysis today // please assess for acute processes
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A right internal jugular central venous catheter tip extends to the superior cavoatrial junction. The size the cardiac silhouette is enlarged but unchanged. Moderate left and small right pleural effusions with overlying atelectasis. No pneumothorax identified. Interval resolution of the pulmonary vascular congestion.
<unk> year old woman with tiss avr // predischarge eval
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The lungs are clear of airspace or interstitial opacity. The cardiomediastinal silhouette is unremarkable. No pleural effusions or pneumothorax. No acute or aggressive osseus changes.
<unk> year old woman with recurrent aspiration pneumonia. new aspiration event a few days ago, now with cough // assess for infiltrate
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There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal and hilar contours are normal.
history: <unk>f with chest pain // r/o ptx
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Pa and lateral views of the chest were provided. Lungs are hyperinflated though appear clear without focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette appears normal. Bony structures are intact. No free air is seen below the right hemidiaphragm.
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The heart is mildly enlarged with a left ventricular configuration. The patient is status post sternotomy. Fissures are mildly thickened, but without evidence for parenchymal edema. A focal opacity projects along the left lung base, new since the prior study, raising concern for pneumonia. The left hemidiaphragm remains mildly elevated. The bones are probably demineralized.
ekg changes and syncope.
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Relatively low lung volumes are noted however the lungs are grossly clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified.
<unk>m with fever, tachycardia, tachypnea, ?acs // ?pulmonary infiltrates, edema
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Lung volumes are normal. No consolidation, effusion or pneumothorax. Cardiomediastinal and hilar contours are normal. No subdiaphragmatic free air.
history: <unk>f with hx ms, presenting with ams, disinhibition // eval for acute cardiopulm processeval for intracranial process, frontal lobe lesions
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Lung volumes are low, unchanged from prior. Heterogeneous, asymmetrically distributed opacities remain more severe on the right than the left and show interval improvement, particularly in the left lungcardiomegaly is unchanged.mediastinal and hilar contours are unremarkable. There is no evidence for pulmonary consolidation, pleural effusion, or pneumothorax.left subclavian port tip terminates in the upper svc, unchanged from prior.
<unk> y.o. f <unk> speaking with multiple medical issues most notable for htn, cad, afib not on anticoagulation, systolic chf (lvef <unk>%), and diffuse large b cell lymphoma on rituximab presents with cough and dyspnea. evaluate for interval change.
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Compared with <unk>, there has been progression of diffuse bilateral opacities. There is more pronounced confluence in the left upper lung and slight oblique greater areas of confluence of the right lung. As before, the right hemidiaphragm is elevated. The cardiac silhouette is obscured by the opacities more so than on the prior study. No gross left effusion. Doubt gross right effusion. Clips again seen in the right upper abdomen. Clips also noted adjacent to the left shoulder. Left-sided line overlies the mid svc, similar prior.
<unk> year old woman with hypersensitivity pneumonitis and hypoxic respiratory failure. also chf // rule out worsening pulmnonary edema versus hp versus aspiration pna
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Frontal and lateral views the chest demonstrate low lung volumes with resulting bronchovascular crowding. Linear opacities within both lungs likely represent atelectasis or scarring. There is mild enlargement of the hila and cephalization of pulmonary vasculature, consistent with mild interstitial edema. There is no focal consolidation or pneumothorax. A right-sided pacemaker device is noted at the leads terminating in the right atrium and right ventricle. Trace bilateral pleural effusions are present. The cardiomediastinal and hilar contours are unchanged. There is mild calcification of the aortic knob.
evaluate for pneumonia.
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No focal consolidation, effusion or pulmonary edema is seen. Cardiomediastinal silhouette is normal. The dextroscoliosis is again seen.
<unk>-year-old woman with cough and tachycardia, evaluate for pneumonia.
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The left lung is clear. Subtle right base opacity is most likely atelectasis/scarring and in part relate to overlying soft tissue. No definite focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are unremarkable.
shortness of breath, history of pneumonia.
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Frontal and lateral views of the chest demonstrate low lung volumes, accentuating perihilar vascular congestion and crowding. The heart is normal in size. Post-cabg changes and median sternotomy wires are present. The thoracic aorta is tortuous with arch calcifications. Retrocardiac opacity likely represents atelectasis. There is no large pleural effusion or pneumothorax. Thoracic kyphosis is unchanged. Right shoulder severe deformity is chronic. Pronounced left shoulder osteoarthritis is present.
<unk>-year-old female with unwitnessed fall. question pneumonia.
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Moderate cardiomegaly with mild tortuosity of the thoracic aorta is unchanged since at least <unk>. Central pulmonary vascular congestion with associated interstitial edema is mild. Increased opacity at the right lung base is more pronounced compared to prior examinations. Pleural surfaces are clear without effusion or pneumothorax.
fever.
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In comparison with study of <unk>, there is again hyperextension of the lungs with flattening of the hemidiaphragms consistent with chronic pulmonary disease. However, no evidence of acute focal pneumonia, vascular congestion, or pleural effusion. Dual-channel pacer device remains in place. Specifically, no evidence of amiodarone toxicity.
possible amiodarone toxicity.
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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 woman with hiv, dm, cad and now chronic cough // r/o chf
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Frontal and lateral views of the chest were obtained. There is no focal consolidation, pleural effusion or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal. In the right posterior ninth rib, there is an edge adjacent to the rib. This most likely represents artifact, but if the patient has pain at this site, this may represent a fracture.
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Frontal and lateral views of the chest demonstrate hyperexpanded lungs. No pleural effusion, focal consolidation or pneumothorax. The heart is moderately enlarged. Descending aorta appears tortuous. There is no pulmonary edema. Hilar and mediastinal silhouettes are otherwise unremarkable. Multiple surgical clips project over right upper abdomen. Pacemaker lead projects over right atrium and right ventricle.
weakness.
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Improved right pleural effusion and perihilar opacification. Small bilateral pleural effusions remain. Unchanged appearance of left picc. Heart size, borders, and mediastinal contours are unchanged.
<unk> year old woman s/p rul // check interval change
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No consolidation is seen. Left picc is unchanged in position. No pleural effusion or pneumothorax is seen. Cardiomediastinal silhouette is unremarkable.
<unk> year old woman with history of asthma with persistent cough. // ? infiltrate ? infiltrate
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Lobe pulmonary opacities consistent with edema, subsegmental atelectasis and bilateral pleural effusions persist. The heart appears enlarged. Mediastinal structures are stable.
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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>f with asthma with r scapular pain, worse with coughing/deep breath // assess for pnthx
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No focal consolidation, pneumothorax, pleural effusion or pulmonary edema is seen. Bilateral nipple shadows appear unchanged. The cardiomediastinal silhouette is stable.
eight days of productive cough.
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Both lungs are well expanded and clear. No lung opacities of concern. The mediastinal and hilar contours are normal.
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The lungs are chronically somewhat hyperexpanded, but clear. There is no focal airspace opacity. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette, hilar contours and pleural surfaces are normal. The aortic arch is calcified. There is severe chronic deformity of the right humeral head.
history: <unk>f with chills // acute process?
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Ap upright and lateral views of the chest provided. A tracheostomy tube is in place with with an overlying oxygen mask. The lung volumes are quite low. Bibasilar opacities are seen most suggestive of atelectasis versus scarring at the right lung base and atelectasis and probable small effusion on the left. The possibility of a superimposed pneumonia is difficult to exclude. The mid to upper lungs appear well aerated. Heart size appears grossly stable. The mediastinal contour is unchanged. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.
<unk>f with dyspnea, increased mucus production - eval for pna
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Ap upright and lateral views of the chest provided. A left chest wall pacer device is seen with lead tips extending to the region of the right atrium and right ventricle. The heart is normal in size. No signs of pulmonary edema or pneumonia. No effusion or pneumothorax. The bony structures are intact. No free air below the right hemidiaphragm.
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Exam is limited with patient's face overlying the left lung apex and relatively low lung volumes. Where seen, the lungs are clear. There is no effusion or large consolidation. Cardiomediastinal silhouette is within normal limits. Of note, the colon is seen projecting below the right hemidiaphragm.
<unk>m with hypothermia, cough, concern for pna // eval pna
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In comparison with study of <unk>, there is continued evidence of vascular congestion with hazy opacification at the bases consistent with bilateral pleural effusions and compressive atelectasis at the bases. The difference in appearance may merely reflect the changes in patient position, with the patient more supine on the current study. Endotracheal tube and nasogastric tube have been removed. There is now a left subclavian catheter that extends to the lower portion of the svc. Single-channel pacemaker device remains in place. Extensive spinal surgery is again evident.
arrest with chf exacerbation.
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Ap upright and lateral views of the chest provided. Lung volumes are markedly low. Cardiomegaly is moderate to severe. No signs of congestion or edema. No focal consolidation concerning for pneumonia. No pleural effusion or pneumothorax. Aortic knob calcification again noted with mildly unfolded thoracic aorta. Bony structures are intact. No free air below the right hemidiaphragm.
<unk>f with altered mental status
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Pa and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. Biapical pleural parenchymal scarring is noted. Lucent appearance of the lungs likely reflects known emphysema. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.
<unk>f with persistent cough, lll rhonchus // eval for pna
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Right-sided port-a-cath tip terminates in the cavoatrial junction. Heart size is normal. The aorta is tortuous, unchanged. Mediastinal and hilar contours are otherwise unremarkable. Pulmonary vasculature is normal. Streaky opacities within the retrocardiac region may reflect atelectasis. Right lung is clear. No focal consolidation, pleural effusion or pneumothorax is seen. Compression deformities of several thoracic vertebral bodies within the mid and lower thoracic spine appear unchanged with associated kyphosis.
history: <unk>m with fall. history of multiple myeloma on chemo // ?pneumonia
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A dual lead pacemaker is noted. There is no discontinuity of the leads which are seen with tips projecting over the right atrium and right ventricle. The cardiac silhouette is enlarged. The pulmonary vasculature is unremarkable. There is no pleural effusion or pneumothorax. No consolidation is identified.
<unk> m with recent pacemaker generator change and feeling of pacemaker firing // eval pacemaker placement, pneumonia, chf
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Pa and lateral chest radiographs demonstrate a heart which is mildly enlarged. There are calcifications of the tortuous thoracic aorta. The lungs are well aerated and without focal consolidation or pneumothorax. There may be a trace effusion on the left side only.
chest pain. evaluate for acute process.
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The cardiac, mediastinal and hilar contours appear unchanged. There is no pleural effusion or pneumothorax. The lungs appear clear. There has been no significant change.
acute onset of dyspnea. history of congestive heart failure.