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The lungs are clear. There is no evidence of pneumonia, pneumothorax, or pleural effusion. Cardiac silhouette is normal in size.
history: <unk>m with mild chest tenderness // evaluate for acute injury
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Right port-a-cath tip projects over the expected location of the low svc. Bibasilar opacities is probably atelectasis in the setting of chronic severe pleural thickening move, although infection should be considered in the appropriate clinical setting. Peripheral opacity at the right lung base adjacent to the fiducial marker reflects changes of radiation fibrosis. No pleural effusion or pneumothorax. Extensive pleural calcification noted on the left. Cardiac silhouette partially obscured by pleural thickening, top-normal size.
<unk>-year-old male with hodgkin's lymphoma status post chemoradiation in <unk> and lingular segmentectomy for squamous cell carcinoma. he presents for evaluation of tachycardia and hypoxia. evaluate for pneumonia.
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Pa and lateral views of the chest demonstrate normal lung volumes without pleural effusion, focal consolidation or pneumothorax. The hilar and mediastinal silhouettes are unremarkable. Heart size is normal. There is no pulmonary edema.
the patient with vomiting blood and coughing for two weeks. assess for pneumonia.
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Pa and lateral chest radiographs demonstrate clear lungs bilaterally without focal consolidation identified. Heart and mediastinal contours are stable in appearance and within normal limits. Hilar contour is unremarkable. There is no pleural effusion or penumothorax. Osseous structures demonstrate no acute abnormality.
history: <unk>m with intermittent chest and back pain.
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Pa and lateral views of the chest provided. Streaky right basilar opacity is likely due to atelectasis given adjacent fat containing bochdalek hernia. The lungs are otherwise clear. The cardiomediastinal silhouette is stable. No acute osseous abnormalities.
<unk>f with sob // pls eval for pulm edema
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The lungs are clear with no evidence of consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. No acute fractures are identified.
evaluation of patient with back pain.
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Ap portable upright radiograph of the chest demonstrates clear lungs and normal hilar cardiomediastinal contours. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal. There is no free air under the diaphragm.
abdominal pain.
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Compared with prior radiographs on <unk>, there is no significant change in a right-sided layering pleural effusion, with fluid in the minor fissure. There is improved aeration at the right lung base. There is no focal consolidation or pneumothorax. Cardiomegaly is unchanged. Median sternotomy wires are stable in position.
<unk> year old man with chf exacerbation, cauti, new low-grade fever overnight with congestion, r/o infiltrate. // r/o infiltrate
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The heart is normal in size. The mediastinal and hilar contours are unremarkable. The lungs appear clear. There are no pleural effusions or pneumothorax. Bony structures are unremarkable.
productive cough and subjective fever and chills; history of cirrhosis.
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The right picc has since been removed. A right-sided port-a-cath is now with in place ending in the region of the cavoatrial junction. The lungs are clear. No focal consolidation, pulmonary edema, pleural effusion, or pneumothorax. No significant change in the appearance of the mediastinal contours and hila. The heart size is normal. <unk> projecting over the midline have been removed.
<unk> year old woman with burkitt's lymphoma, getting r-ivac. temperature to <num>.<unk> yesterday. // looking for evidence of infiltrate or infection
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No previous images. The heart is normal in size and lungs are clear without vascular congestion or pleural effusion.
possible pneumonia.
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Pa and lateral chest views were obtained with the patient in upright position. Comparison is made with the next preceding single view chest examination obtained four hours earlier during the same day. On the present examination, the apical right-sided pneumothorax has increased in size and measures now <num> to <num> cm in width surrounding the apical area. No marked decrease in lung volume and no new pulmonary infiltrates are identified. The right-sided port-a-cath system remains in unchanged position. No new pulmonary abnormalities or pneumothorax in the left hemithorax. Lateral view discloses that the pneumothorax separation reaches also anteriorly as well as posteriorly terminating with a small loculated air-fluid level at the level of the eighth vertebral body of the thoracic spine as seen on the lateral view. No other new pulmonary or pleural abnormalities are identified. There exists moderate gas distension of the bowel pull-through in the right-sided mediastinal area. Increase in right-sided pneumothorax was observed and immediately submitted via page to <unk> at <time> p.m.
<unk>-year-old male patient status post esophagectomy six days ago, evaluate for pneumothorax after ct removal.
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Redemonstration of vascular stents about the right superior mediastinum is noted. No pneumothorax or pleural effusions are seen. No focal consolidations are seen to suggest an acute infectious process. Heart size is within normal limits. Mild degenerative changes are seen within the thoracic spine.
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An endotracheal tube is noted with the tip in the lower trachea. An enteric tube is noted traversing into the stomach. The heart appears enlarged. There are bilateral increased opacity likely representing redistributed edema. No acute fractures are identified. The ascending aorta appears slightly dilated.
status post intubation.
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In comparison with the earlier study of this date, there has been placement of an endotracheal tube, with its tip approximately <num> cm above the carina. Nasogastric tube and left subclavian catheter are essentially unchanged. Otherwise, there is little overall change in the diffuse opacifications involving both lungs as on the previous study.
ventral hernia repair.
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A dual lead pacemaker is again seen with the tips in the right atrium and right ventricle. The heart remains mildly enlarged. Mild pulmonary vascular congestion, is chronic and unchanged. No pleural effusions or pneumothorax no acute focal consolidation. The bone mineral density is diffusely reduced with mild wedging of the lower thoracic vertebral body height and multiple healing rib fractures are seen on the right.
<unk> year old woman awaiting mri who has a pacemaker // please evaluate placement and lead positioning
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A left pectoral pacemaker is seen with a transvenous lead in the right ventricle. The lungs are clear. Heart size is top normal. Median sternotomy wires are intact and aligned. Right rib deformities are compatible with old rib fractures. No pneumothorax.
<unk> year old man with icd // evaluate for lead position
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No definite consolidation is identified. Opacity in the right base is felt to more likely represent crowded vessels with possible bronchiectasis, rather than a developing infection. No pneumothorax or pleural effusion is identified. The heart size is normal. Picc line tip is within the low svc.
known osteomyelitis and urinary tract infection with persistent fever.
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Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac silhouette remains mildly enlarged. Mediastinal contours are stable. No pulmonary edema is seen.
<unk> year old man with actue onset left lower rib pain. // please eval for e/o fracture or ptx
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Exclusion of lung apices limits evaluation for apical pneumothorax. With this limitation in mind, no gross pneumothorax is evident. Endotracheal tube terminates <num> cm above the carina, nasogastric tube is coiled within the esophagus with distal tip directed cephalad at approximately the t<num> vertebral body level, and this finding has been communicated by telephone to dr. <unk> on <unk> at <num> a.m. At the time of discovery. Cardiomediastinal contours are stable in appearance. Bilateral, asymmetrically distributed predominantly perihilar airspace opacities are again demonstrated, worse on the right than the left. Since <unk>, the right-sided opacities have slightly improved, and the left have worsened. Differential diagnosis includes aspiration pneumonia (given history of seizure) and asymmetrical pulmonary edema.
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The lungs are fully expanded and clear. Resolution of bilateral pulmonary infiltrates. Cardiomediastinal and hilar silhouettes are normal. Pleural surfaces are normal. A left upper lobe calcified granuloma once again visualized.
<unk> year old man with seizure concerning for aspiration pna // evaluate for resolution of opacities concerning for infection
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There is a tortuous and calcified thoracic aorta. The cardiomediastinal silhouettes are stable. As on prior exams, diffuse interstitial prominence and stable moderate cardiomegaly is consistent with mild pulmonary edema. Prominence of the right hilum is unchanged. There is improved aeration of the left lung base in comparison to prior radiograph. There is no focal lung consolidation. There is no pneumothorax or pleural effusion.
an <unk>-year-old woman with chest pain, evaluate for pneumonia.
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The costophrenic angles are not fully included on the lateral view. Frontal and lateral views of the chest were obtained. There are low lung volumes, which accentuate the bronchovascular markings. Given this, no focal consolidation, large pleural effusion, or evidence of pneumothorax is seen. The cardiac, mediastinal, and hilar contours are stable. Degenerative changes are seen in the acromioclavicular joint. Degenerative changes are seen along the spine.
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There are small bilateral pleural effusions. No focal consolidation or pneumothorax is seen. Heart and mediastinal contours are within normal limits. Aortic arch calcifications are seen. A linear coiled density projects over the anterior upper abdomen.
<unk>-year-old female with sickle cell disease and fever.
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An endotracheal tube has been placed and terminates in the mid portion of the trachea. An orogastric tube terminates in the stomach. A port-a-cath terminates in the right atrium. Although the left lung base is much better aerated than before, there is, if anything, more extensive diffuse but heterogeneous bilateral lung opacification elsewhere, worrisome for a rapidly developing infectious process or perhaps pulmonary edema. There is no definite pleural effusion or pneumothorax. Bilateral ureteral stents are present. Diffuse bony sclerosis suggests metastatic disease.
status post endotracheal intubation.
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Pa and lateral views of the chest provided. Midline sternotomy wires again noted. The aorta is prominent in this patient with known dilation of the thoracic aorta better assessed on prior ct. Heart size is normal. Lungs are clear. There is no focal consolidation, effusion, or pneumothorax. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.
<unk>f with mvc // eval for trauma
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As compared to the previous radiograph, the monitoring and support devices are in unchanged position. The extent of the bilateral pleural effusions is constant, as are the areas of subsequent bilateral atelectasis at the lung bases. A linear opacity on the right is caused by a skinfold. No newly appeared parenchymal opacities. Normal size of the cardiac silhouette.
evaluation for interval change.
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Frontal and lateral radiographs of the chest demonstrate low lung volumes, which results in bronchovascular crowding. There is a nonspecific chronic interstitial abnormality of uncertain clinical significance. The cardiomediastinal and hilar contours are unchanged. There is no pneumothorax, pleural effusion, or consolidation. No acute displaced rib fractures identified.
history: <unk>f with right sided chest pain // r/o ptx
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Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable and unremarkable. No displaced fracture is identified.
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A chest tube overlies the base of the right lung. There is a small right pleural effusion and adjacent pulmonary opacity at the right base, which likely reflects atelectasis. Multiple rounded opacities are seen throughout both lungs consistent with known pulmonary nodules, better appreciated on recent chest ct from <unk>. The cardiomediastinal and hilar contours are within normal limits. There is no left effusion. Small hydropneumothorax at the right apex.
<unk> year old man with rcc and pulmonary mets, s/p pleurodeisis and chest tube placement by ip // c/f lung expansion, pleural effusion re-accumulation
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Since prior, endotracheal tube has been retracted now ends approximately <num> cm above the carina. Nasoenteric tube has also been retracted ending at or just above the level of the ge junction. There is a developing left basilar opacity. There is linear atelectasis at the right lung base. There is no pneumothorax or pleural effusion.
<unk>f with subarachnoid hemorrhage, endotracheal tube repositioning.
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Since the prior study the right picc is been removed. The lungs are clear with no consolidation to suggest pneumonia. No pulmonary edema or pleural effusions. Heart size and mediastinal contours are normal. No pneumothorax.
history: <unk>f with ams< no focal deficits, responsive to verbal stim,. evaluate for acute cardiopulmonary process.
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The cardiomediastinal and hilar contours are stable. There is increased retrocardiac density compared to the prior study which suggests atelectasis however infection should be considered. There are no large pleural effusions identified. Scattered pulmonary opacities are seen throughout the bilateral lungs which may be related to persistent edema or a chronic interstitial process. No pneumothorax is identified. Pleural calcifications are seen and are unchanged from the most recent prior study.
<unk> year old man with history of dchf, copd, here with new ascites and <unk>. also with new o<num> requirement on <num>l nc. // eval for pulmonary edema, effusions, consolidations
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Pa and lateral views of the chest demonstrates the lungs are well expanded with no evidence of pneumothorax, focal consolidation or pulmonary edema. Bilateral apical pleural thickening is again seen. The cardiomediastinal silhouette is stable in appearance.
difficulty breathing with abdominal distention.
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Lungs are hyperinflated. Heterogeneous airspace opacities are predominantly present in the right lower and to a lesser extent in the right upper and middle lobes. There are subtle opacities in the left lower lobe as well. Heart is normal size and cardiomediastinal silhouette is stable. There is no pulmonary edema. No pleural effusion or pneumothorax.
<unk> year old man with copd // aspiration pna
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The heart is at the upper limits of normal size. The mediastinal and hilar contours appear within normal limits. There is no pleural effusion or pneumothorax. The lungs appear clear. Mild-to-moderate degenerative changes are noted along the mid-to-lower thoracic spine with mildly prominent marginal osteophytes including a prominent right lateral bridging osteophyte along the mid thoracic spine. The lower thoracic spine also shows mild rightward convex curvature.
chest pain. history of hiv.
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Frontal and lateral views of the chest demonstrate slightly low lung volumes, accentuating cardiomediastinal silhouette. Allowing for such, the lungs are clear, without pneumothorax, vascular congestion, or pleural effusion. Moderate lower thoracic spondylosis is present.
<unk>-year-old male with unstable angina. question acute process.
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Moderate-to-severe cardiomegaly and mild widening of the mediastinum is chronic and unchanged since at least <unk>. Scattered parenchymal opacities particularly at the lung bases as well as spiculated areas of probable scarring in the lung apices are unchanged since <unk>. There is no clear superimposed opacity. There is no pleural effusion or pneumothorax.
shortness of breath status post fall with head strike, on anticoagulation.
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The heart is borderline in size. The aortic arch is calcified. There is a convex contour to the upper right mediastinum with a smooth outer contour; most often, this appearance is due to tortuosity of the great vessels and appears benign. Aside from streaky left basilar opacity suggesting atelectasis, the lungs appear clear. There is no pleural effusion on the right. Slight blunting of the left costophrenic angle may reflect a minimal effusion on the left side, however. Moderate degenerative changes affect the partly imaged upper lumbar spine.
bradycardia.
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The lungs are hyperinflated with the known left upper lobe mass less well appreciated on the current radiograph than on the prior ct from <unk>. Since the prior study, there is new opacification of the left lower lung, which could represent a combination of atelectasis, parenchymal consolidation, and pleural fluid. Mild cardiomegaly is again noted.
<unk> year old woman with lung cancer, here with lethargy. evaluate for pneumonia
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Sternotomy wires and mediastinal clips are unchanged. There has been interval removal of the right ij central venous catheter. The heart size is at the upper limits of normal. The mediastinal and hilar contours are unremarkable. A small left pleural effusion is present, prior right effusion has cleared. There is no overt evidence of edema or failure. No pulmonary consolidation is present. There is no pneumothorax.
<unk>-year-old male status post cabg three weeks ago, now with shortness of breath.
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The patient is status post coronary artery bypass graft surgery. The cardiac, mediastinal and hilar contours appear unchanged. There is persistent opacification of the left lung base with a pleural effusion, but probably decreased somewhat. What is new, however, is an opacity in the right lower lung, probably in the right lower lobe, noting that it does not silhouette either the right cardiac border or hemidiaphragm.
shortness of breath. status post coronary artery bypass surgery.
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Minimal right base atelectasis seen. There is no focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable.
history: <unk>f with syncope, headstrike, hematoma to back of head // eval for intracranial bleed, acute process
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The lungs are hyperinflated. There is no evidence of focal consolidation, pleural effusion, pneumothorax, or frank pulmonary edema. Biapical pleural thickening is noted. An oval calcified density is noted within the right lung apex overlying the right scapula and portions of the posterior right fourth rib, likely of little clinical significance. The cardiomediastinal silhouette is within normal limits.
history: <unk>m with cough, fevers // infiltrate?
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Pa and lateral views of the chest provided. Left port-a-cath terminates in the right atrium. Postsurgical changes are stable. Bilateral, opacities along the lateral chest wall are not significantly changed given differences in lung volumes no pneumothorax. Right-sided pleural effusion is better seen on ct from earlier today. Hilar and cardiomediastinal contours are normal.
history: <unk>f with n/v // eval for infiltrate
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The cardiomediastinal and hilar contours are within normal limits. The lung fields are clear. There is no pneumothorax, fracture or dislocation. Limited assessment of the abdomen is unremarkable.
history: <unk>m with s/p mvc, known subcapsular renal hematoma // assess for traumatic injury, pnthx
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This image was just submitted for evaluation. In comparison with the study of <unk>, the endotracheal tube has been removed. Nasogastric tube extends to the stomach and swan-ganz catheter is in the pulmonary outflow tract. Continued substantial prominence of the right hilar region.
post-redo aorta replacement.
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There is still a moderate-sized right pleural effusion, but is decreased compared to the film from the prior day. There is no pneumothorax. The left lung is clear.
status post thoracentesis.
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The previously seen right ij line has been removed. No pneumothorax is detected. Again seen is a left-sided single lead pacemaker (transvenous right ventricular pacer defibrillator) with lead over the right ventricle. Lordotic positioning. Again seen are low inspiratory volumes. Stable prominence of the cardiomediastinal silhouette, with fixation hardware again noted -- this appearance is likely accentuated by ap technique, low volumes, lordotic positioning. There is increased retrocardiac density, consistent with left lower lobe collapse and/or consolidation, overall similar to the prior study. Patchy right perihilar opacity is are also similar, possibly slightly more pronounced. Equivocal vascular engorgement. No gross effusion.
<unk> year old man with tachypnea/labored breathing, saturating well, afebrile, known chf // ?chf exacerbation vs pneumonia
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As compared to the previous radiograph, there is no relevant change. Minimal opacity at the level of the right cardiophrenic angle, potentially reflecting a pericardial fat pad or a pericardial cyst. No new parenchymal opacities have appeared in the lung parenchyma. Borderline size of the cardiac silhouette without evidence of pulmonary edema. No pleural effusions. No pneumothorax. The right-sided picc line has been removed in the interval.
cll and fever, rule out pneumonia.
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Pa and lateral views of the chest. Left-sided pacemaker with the wires in appropriate position. There is no focal consolidation, pleural effusion, or pneumothorax. There is mild cardiomegaly. The mediastinal and hilar contours are normal.
mid chest discomfort, evaluate for pneumonia.
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Compared with the prior study, there is a new endovascular aortic graft. Heart size is top normal. Increased right basilar opacity may be due to atelectasis and layering pleural fluid. There is also a small left pleural effusion. No new focal consolidation or pneumothorax.
<unk> year old man s/p tavr. please assess for cardiopulmonary process.
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Again seen is prominence bilateral hilar right greater than left compatible with patient's known mediastinal and hilar adenopathy the left main bronchus stent is visualized in good location with takeoff just adjacent to the carina there is a small amount of volume loss in both lower lobes.
mediastinal adenopathy and left mainstem.
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The patient is status post coronary bypass surgery. The cardiac, mediastinal and hilar contours appear stable. A patchy but extensive opacity in the left upper lobe suggesting pneumonia has improved to some extent. The right lung remains clear. There is perhaps a trace pleural effusion on the left, but no definite right-sided effusion. There is a moderate hiatal hernia. The cardiac, mediastinal and hilar contours appear stable.
pneumosepsis.
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The patient is intubated. The endotracheal tube terminates about <num> cm above the carina. An orogastric tube terminates probably just short of the left hemidiaphragmatic inlet. A streaky left mid lung opacity suggests minor atelectasis. Otherwise, the lungs appear clear within the limitations of technique. There is no definite pleural effusion or pneumothorax.
intracranial hemorrhage status post intubation.
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As compared to the previous radiograph, there is a generalized increase in diameter of the vascular structures, suggesting mild fluid overload. The cardiac silhouette is unchanged to the previous examination, mildly enlarged. No larger pleural effusions. At the right lung base, consistent with the ct examination performed on <unk>, fibrotic changes are noted. There is no evidence of pneumothorax. The alignment of the sternal wires is unremarkable.
endobronchial lesion, evaluation for post-operative change.
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As compared to the previous radiograph, there is an old left rib fracture and a status post partial rib resection. The changes result in pleural thickening and abnormal rib contours on the left. The changes are better documented on a ct examination from <unk>. Borderline size of the cardiac silhouette. No evidence of acute lung changes such as pulmonary edema or pleural effusions. No evidence of pneumonia. Borderline size of the cardiac silhouette.
adenocarcinoma, questionable pneumonia.
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Moderate interval increase in diffuse bilateral heterogeneous opacities with air bronchograms and focal increased opacity in the right lower lobe. Heart size, mediastinal contour are obscured by the pleural parenchymal process. No pneumothorax or large pleural effusion. No bony abnormality.
<unk>-year-old female status post suicide attempt and aspiration. assess interval change.
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Since the previous study, there has been decrease in the size of the left-sided loculated pleural effusion on the left chest wall. Plaques at the lung bases are visualized and consistent with prior asbestos exposure. Heart size is within normal limits.
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As compared to the previous radiograph, there is no relevant change. The monitoring and support devices are constant, unchanged distribution and severity of the pre-existing bilateral parenchymal opacities. Unchanged size of the cardiac silhouette. No larger pleural effusions. No new parenchymal changes.
tracheobronchomalacia, intubation, evaluation for interval change.
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There are relatively low lung volumes, which accentuate the bronchovascular markings. Given this, there may be mild pulmonary vascular congestion. No definite focal consolidation is seen. There is no pleural effusion or evidence of pneumothorax. The cardiac silhouette is top-normal. The aorta is slightly tortuous.
syncope versus seizure, vertigo.
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Single ap view of the chest provided. <num> cm left upper lobe mass is unchanged from <unk>. Interstitial lung markings at the lung bases, new since <unk> could be early edema. Followup advised. . No pleural effusion or pneumothorax. Hilar and cardiomediastinal contours are normal.
<unk> year old man with lul mass s/p tbbx // post bronch
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The cardiomediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax. The lungs are well-expanded with mild bibasilar atelectasis. There is no focal consolidation concerning for pneumonia. Surgical clips projecting over the right axilla and median sternotomy wires are noted.
history: <unk>m with eval dissection/graft issue // hx of type a dissection s/p repair, p/w sharp r sided chest pain radiation to back
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Portable ap upright chest radiograph obtained demonstrates midline sternotomy wires. There is increasing left pleural effusion. Evaluation limited due to exclusion of the left lower lateral chest. There is small right pleural effusion. There may be mild pulmonary interstitial edema. The heart size cannot be assessed. The aorta is unfolded. No pneumothorax.
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In comparison with study of <unk>, the tip of the nasogastric tube has been pulled back to the upper body of the stomach. The side hole is at approximately the level of the esophagogastric junction.
pullback of nasogastric tube.
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Interval removal of the enteric tube. The right picc line is in unchanged position. Pulmonary edema and pulmonary venous congestion have worsened. Bilateral lower lobe consolidation likely atelectasis is unchanged. Superimposed pneumonia cannot be ruled out. The right upper lobe also has increase ill-defined opacification concerning for pneumonia. Bilateral pleural effusions have worsened. The cardiomediastinal silhouette is unchanged. No pneumothorax.
<unk> year old woman with new leukocytosis and prior tube feeding w/ams // aspiration? pna? effusion?
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Moderate enlargement of the cardiac silhouette appears slightly increased compared to the previous examination. Atherosclerotic calcifications are noted at the aortic knob. There is mild pulmonary vascular congestion without frank pulmonary edema. Small left pleural effusion is new along with retrocardiac patchy opacity, likely atelectasis. No pneumothorax is detected. Multiple clips are demonstrated within the neck compatible prior thyroidectomy. Clips are also seen within the upper abdomen. There are moderate multilevel degenerative changes seen in the thoracic spine.
history: <unk>f with chest pain and atrial fibrillation, feels fatigued, question pneumonia
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The heart size is normal. Opacification within the medial left upper lobe appears more consolidated when compared to the prior chest radiograph, but appears relatively unchanged compared to the ct from <unk> and is compatible with the patient's known lung mass with adjacent radiation fibrosis. Scarring within the right lung apex is stable. Emphysematous changes are again noted. No new areas of focal consolidation are seen. There is no pleural effusion or pneumothorax. The pulmonary vascularity is not engorged. Compression deformities of the t<num> and t<num> vertebral bodies are unchanged.
shortness of breath after recent hospital admission and cardiac catheterization.
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The lungs are clear within the limitation from overlying soft tissues. There is no consolidation, effusion, or vascular congestion. The cardiomediastinal silhouette is within normal limits.
<unk>m with sob, known pes // eval for infilrate
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Left chest wall port catheter terminates in the upper right atrium. Lungs are clear. There is no pleural effusion or pneumothorax. Cardiomediastinal contour is normal.
history: <unk>f with dyspnea. evaluate for pneumonia
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Left subclavian line that was going into right subclavian vein has been repositioned and now ends in the mid-to-lower svc. Right-sided picc line also ends in lower svc. Et tube is <num> cm above carina. Pigtail projects in the left upper abdominal quadrant. Low lung volumes with bibasilar atelectasis is unchanged. Pleural effusions are small if any. New catheter projects in the mediastinum could be compatible with thermal probe. Ng tube is in the stomach.
patient with hypoxia, pneumonia, effusion or pneumothorax.
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There is a moderate right pneumothorax has slightly increased in size compared to prior. Otherwise no change in the right-sided chest tube, right rib fractures, pacemaker, left pleural effusion, and volume loss in the right midlung
<unk> year old man s/p mvc with r <unk>th rib fx, pulm contusions, r hemothorax s/p r ct placement now to ws w/new bubbles in output. // rule out new ptx, htx
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Pa and lateral views of the chest provided. Left chest wall aicd is seen with leads extending to the region of the right atrium, right ventricle, and coronary sinus. There is no focal consolidation, large effusion or pneumothorax seen. Mild bibasilar atelectasis is better assessed on same-day ct abdomen pelvis. Cardiomediastinal silhouette appears grossly within normal limits. Bony structures are intact. No free air below the right hemidiaphragm.
<unk>m with fever, leukocytosis, no source
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In comparison with the study of <unk>, the monitoring and support devices remain in place. Again there are low lung volumes with some increasing opacification at the bases, especially on the right. Although this most likely represents atelectasis, in the appropriate clinical setting, supervening pneumonia would have to be considered.
possible aspiration with gi bleed.
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Frontal lateral radiographs of the chest demonstrates a left chest wall port-a-cath with the tip in the region of the cavoatrial junction. A disc shaped foreign bodies projects in the anterior chest wall soft tissues. Slight increase in mild cardiomegaly. No focal consolidation, pleural effusion or pneumothorax.
fever, question pneumonia.
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Frontal and lateral views of the chest were obtained. Mild left base atelectasis. No focal consolidation, pleural effusion, or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable.
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Pa and lateral views of chest demonstrate clear lungs. Heart size is normal. No pleural effusion pneumothorax or pulmonary edema.
pleuritic chest pain
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On the lateral view, there is posterior basilar opacity worrisome for pneumonia. This is less well seen on the frontal view, likely partially obscured by the diaphragm, but he is most likely within the right lower lobe on the frontal view. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable.
history: <unk>m with fevers, cough, pain in chest from coughing // ? pneumonia
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In comparison with study of <unk>, there has been placement of a right chest tube with a small to moderate amount of pleural effusion. No recent images available for comparison. No definite pneumothorax. Increased opacification at the right base could reflect some combination of atelectasis, superimposed pneumonia, or even re-expansion edema. On the left, there is a larger pleural effusion, similar or even increased from the prior study.
chest tube placement, to assess for pneumothorax.
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Frontal and lateral views of the chest demonstrate stable prominent cardiac silhouette as compared to one year prior. There are atherosclerotic calcifications in the aortic arch. Patient is status post median sternotomy and aortic valve as well as cabg. There are mild interstitial changes in the upper lungs which appears similar to perhaps slightly increased. The lungs appear otherwise clear. There is no pneumothorax, vascular congestion, or pleural effusion. A large hiatal hernia is redemonstrated. Displaced right humeral fracture is unchanged in configuration since at least <unk>. Marked kyphosis is also unchanged. Allowing for significant diffuse osteopenia, no new compression fracture is evident.
<unk>-year-old female with back pain. question pneumonia.
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Ap and lateral views of the chest. Lateral view is limited secondary to motion. The lungs are clear of focal consolidation, effusion or overt pulmonary edema. The cardiac silhouette is mildly enlarged but unchanged. Sternotomy wires are identified as well as tricuspid and aortic valve replacements. No acute osseous abnormality is identified.
<unk>-year-old male with history of chf and cabg, avr with fever and altered mental status.
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Upright portable radiograph of the chest demonstrates unchanged position of dual-lead aicd, with leads terminating in the right atrium and right ventricle. The cardiac size is unchanged since the prior study, and there is a new pericardial drain in place. Increased retrocardiac opacification is likely due to atelectasis, and increased bilateral interstitial markings reflect mild underlying edema. Bilateral reticular opacities are unchanged due to interstitial pulmonary fibrosis, along with stable left apical scarring. There is no pneumothorax. The proximal esophagus is distended with air, possible due to dysmotility.
<unk>-year-old female with pericardial drain placement following right ventricular puncture during aicd placement. now with worsening hypotension and hypoxemia. evaluation for pneumonia.
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Ap portable upright view of the chest. The right ij central venous catheter is new from prior exam extending into the region of the lower svc. Evaluation is suboptimal due to patient rotation to the left. Allowing for this, no further change.
<unk>m with rij placement // ? line placement
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Patient is status post esophagectomy with gastric pull through and sutures are seen in the right perihilar region. The right lung is well expanded and clear. A homogeneous opacity in the left hemithorax is seen obscuring the left diaphragmatic surface and heart and is consistent with a large left pleural effusion with left lower lobe atelectasis, which is unchanged since <unk>. Mild prominence of the right hilum is likely related to patient rotation. Limited assessment of the upper abdomen demonstrates multiple fluid-filled loops of small bowel with air-fluid levels. The gastric pull-through also appears fluid filled. An enchondroma vs. Infarct is noted in the left humeral neck. No interval change in the anterior wedge compression fracture in the lower thoracic spine.
generalized weakness and acute renal failure. assess for pneumonia or pulmonary edema.
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Heart size, mediastinal and hilar contours are normal. Elevation of right hemidiaphragm with indistinctness of the lateral third of the diaphragm contour could potentially be due to pleural and parenchymal scarring given the presence of a loculated pleural effusion in this region on the older radiograph. A small chronic right pleural effusion cannot be excluded, and standard pa and lateral radiographs may be helpful for more complete assessment prior to discharge. Lungs and pleural surfaces are otherwise clear.
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As compared to the previous radiograph, there is a slight improvement with an increase in lung volumes and a subsequent decreased in severity of the pre-existing left perihilar and right apical parenchymal opacity. This increase, however, could also be due to increased ventilatory pressure. The large cavitary lesion at the right lung bases is unchanged in appearance. Also unchanged is the moderate right pleural effusion. The size of the cardiac silhouette is constant. Constant monitoring and support devices.
elevated white blood cell count, questionable interval change.
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Pa and lateral views of the chest provided demonstrate no focal consolidation, effusion or pneumothorax. The cardiomediastinal silhouette is normal. The bony structures are intact. No free air below the right hemidiaphragm is seen.
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In comparison with the study of <unk>, the tracheostomy tube remains in place and the central catheter has been removed. Minimal areas of increased opacification are again seen at the bases, most likely reflecting streaks of atelectasis. No vascular congestion or acute focal pneumonia.
fever with increased sputum.
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No acute focal consolidation. The lungs are clear, no interstitial pulmonary edema. Linear opacity from the right hilum, likely azygos fissure. Moderate cardiomegaly. No significant pleural effusions. No pneumothorax.
<unk> year old man with h/o stroke/aspiration, presenting with malaise and fatigue // ? pna
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The lungs are well expanded and clear with minimal blunting of the left costophrenic angle on the lateral view which could reflect trace pleural effusion or pleural thickening. There is no pneumothorax. The heart is normal in size with normal cardiomediastinal contours.
confusion.
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Left-sided aicd/pacemaker device is noted with leads terminating in the right atrium and right ventricle, unchanged. Moderate cardiomegaly persists. Right picc tip terminates within the svc. Mild interstitial pulmonary edema is noted, not significantly changed from the prior exam, with continued small bilateral pleural effusions, right greater than left. No pneumothorax is identified, and no new areas of focal consolidation are demonstrated. Several compression deformities within the thoracic spine are unchanged.
congestive heart failure with dyspnea.
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Pa and lateral chest radiographs were obtained. The lungs are well expanded and clear. There is no focal consolidation, effusion, or pneumothorax. Cardiac and mediastinal contours are normal.
chest pain.
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The cardiomediastinal silhouette and pulmonary vasculature are normal. The lungs are clear. There is no pleural effusion or pneumothorax.
history: <unk>f with vomiting and epigastric pain // evaluate for free air
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The lungs are clear. Cardiac silhouette is normal. No pleural effusion or pneumothorax. Overlying the tip of the right scapula is an ovoid density measuring approximately <num> mm.
fever.
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Normal heart size, mediastinal and hilar contours. Minimal patchy opacity at the left lung base could reflect atelectasis or aspiration. . No focal consolidation, pleural effusion or pneumothorax.
history: <unk>f with significant etoh intoxication // eval ? aspiration
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In comparison with study of <unk>, there is little interval change. Persistent opacification at the right base laterally that could represent a minimal pleural effusion or pleural scarring with mild atelectatic change. No evidence of vascular congestion or acute focal pneumonia.
pleural effusion.
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The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax.
history: <unk>f with presyncope rates <num>'s // acute process
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There is no evidence of focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits.
history: <unk>m with chest pain // eval for pneumothorax
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Frontal and lateral views of the chest. There is subtle increased reticular markings at the right lung base laterally which appear chronic. The lungs are clear of new consolidation or large effusion. There may be some residual fluid within the right major fissure inferiorly. Calcified granuloma at the right lung base. Cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.
<unk>-year-old male with shortness of breath and wheezing.
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Frontal and lateral views of the chest were obtained. In comparison to the prior study, there has been interval decrease in the right basilar opacity with residual basilar opacity remaining. No large pleural effusion is seen, although a very trace residual right pleural effusion is difficult to exclude. The left lung is clear. Cardiac and mediastinal silhouettes are stable and unremarkable. There is stable ill-defined opacity in the lateral left upper lung.