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Increased heart size, pulmonary vascularity, similar. More prominent interstitial and nodular thickening right lung base, may represent pneumonitis. Large esophageal hiatal hernia. Thoracolumbar curve. Left shoulder arthroplasty. Advanced degenerative arthritis right shoulder. Suggestion of osseous loose body right subcoracoid recess.
<unk> year old woman with hip fx and nstemi // ?transfusion rxn
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Small bilateral pleural effusions with overlying atelectasis. Mild pulmonary vascular congestion without frank pulmonary edema. No pneumothorax identified. The size and appearance of the cardiomediastinal silhouette is unchanged.
<unk> year old man with shortness of breath // r/o pneumonia, volume overload
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Heart size is normal. There is increased ap dimension of the chest. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen. Again, the bones are diffusely demineralized and there is compression deformities of few thoracic vertebral bodies, not significantly changed.
<unk> year old woman with worsening shortness of breath. // pulmonary edema? new pna?
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Heart size is normal. Calcified lymph nodes are seen in the left hilar region as well as calcified nodules in the right lung base, compatible with prior granulomatous disease. Mediastinal and hilar contours are otherwise unremarkable. Pulmonary vasculature is normal. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is present. No acute osseous abnormality is visualized.
history: <unk>m with syncopal episode
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Lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. Gastric stimulator leads are identified in the upper abdomen. No acute osseous abnormalities.
<unk>m with leg weakness, recent treatment for asthma exacerbation // eval for acute process
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Pa and lateral views of the chest are compared to previous exam from <unk>. There is a left lower lobe consolidation compatible with pneumonia. There is also vague right basilar opacity, difficult to localize on the lateral, but potentially within the lower lobe. Superiorly, the lungs are clear. The cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable.
<unk>-year-old female with fever and cough.
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The lung volumes are low which causes crowding of the bronchovascular structures. Linear scarring and atelectasis in the left lung is unchanged. There is no pneumothorax or large pleural effusion. There is a prosthetic heart valve and median sternotomy wires.
<unk>m with chf, etoh use, recent pneumonia presenting with chest pain. evaluate for pleural effusions.
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Left picc tip terminates in the low svc. Right-sided central venous catheter tip terminates in the low svc. Low lung volumes are present. Heart size is normal. Mediastinal and hilar contours are unremarkable. Pulmonary vasculature is not engorged. Patchy opacities within the lung bases likely reflect areas of atelectasis, with no focal consolidation identified. Small bilateral pleural effusions, more pronounced on the right, are new in the interval. No pneumothorax is present. No acute osseous abnormality is seen.
history: <unk>m with pancreatic cancer, abd distention // picc line position
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The lungs are clear. The cardiomediastinal silhouette is within normal limits. Chronic posttraumatic changes noted at the right shoulder.
<unk>m with l knee swelling pre op for i and d washout // preop for ortho surgery
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Pa and lateral views of the chest provided demonstrate mild cardiomegaly and hilar congestion with mild interstitial edema. There is likely a small left pleural effusion. Bony structures are intact. Mediastinal contour stable.
<unk>-year-old man with hypertension, diabetes, hyperlipidemia, asthma with shortness of breath and lower extremity edema, crackles on exam, question chf.
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In comparison with study of earlier in this date, there is little overall change. Substantial enlargement of the cardiac silhouette with diffuse pulmonary edema and bilateral pleural effusions, worse on the right. Some of the opacification in the right hemithorax could well reflect underlying consolidation as suggested in the clinical history.
bronchoscopy and hypoxia.
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Since <unk>, there is increased left lung pneumothorax with unchanged small left pleural effusion and increased atelectasis. The right lung is hyperinflated due to emphysema. The cardiomediastinal silhouette and hilar structures are normal.
<unk>m with history of copd, with history of spontaneous pneumothoraces in the past, s/p blebectomy and pleurodesis in the past, who presents with recurrent small basilar left ptx // assess for interval change in left pneumothorax
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The lungs are well-expanded and clear. Mediastinal contours, hila, and cardiac silhouette are normal. Biapical pleural thickening is unchanged. No pleural effusion.
<unk> year old man with fever, cough, congestion // r/o infiltrate
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A right-sided port-a-cath terminates at the cavoatrial junction. Surgical fixation hardware projects over the cervicothoracic spine. Surgical clips project over the left chest wall and axilla. The heart is normal in size. Multiple soft tissue density masses and nodules are seen throughout both lungs suggestive of metastatic lung disease, however no priors are available for comparison. The lungs are otherwise clear with no focal consolidation, pleural effusion or pneumothorax.
<unk> year old woman with history of melanoma and port placed at outside facility. // confirm line placement
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The cardiomediastinal silhouette is stable and within normal limits. The hila are unremarkable. Re-identified is the airspace opacity within right lower lobe which is persistent however improved in comparison to the prior study. There is no new focal lung consolidation elsewhere. There is no pulmonary vascular congestion or pulmonary edema. There is no pneumothorax or pleural effusion.
<unk>-year-old man with pneumonia on broad-spectrum antibiotics, evaluate for progression or resolution.
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There is moderate to severe cardiomegaly unchanged from prior study. The hila and pleura are normal. There is no vascular congestion or pulmonary edema. There is right lower lobe peribronchial thickening but no focal opacifications or pleural effusions seen.
<unk> year old woman with cough, sputum; hx of chf // ? pneumonia, chf
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Pa and lateral views of the chest provided. There has been interval removal of the port-a-cath. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.
<unk>m with aml on chemotherapy, presenting for evaluation of headache and cough // pna?
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As compared to the previous radiograph, the position of the endotracheal tube is unchanged. The tip of the tube is located <num> cm above the carina. All other monitoring and support devices are constant. The transparency of the left lung base has slightly increased, likely reflecting improved ventilation. No other changes.
endotracheal tube placement.
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Comparison is made to previous study from <unk>. There has been removal of the endotracheal tube and feeding tube since the previous study. There is a right-sided central line with the distal lead tip in the mid svc. Study is somewhat limited due to obliquity in positioning of the patient. There is cardiomegaly. There are again seen diffuse airspace opacities with loculated pleural fluid along the right lateral chest wall. A left-sided pleural effusion is seen. There is also likely an element of pulmonary edema. No pneumothoraces are identified.
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As compared to the prior examination, there has been interval improvement in the patient's now mild pulmonary edema. Small, bilateral pleural effusions are unchanged. An appearant air-fluid level overlies the right lower lobe, although this may represent a simple pleural effusion adjacent to aerated lung. Stable, severe cardiomegaly. Unchanged appearance of an ascending aortic endograft.
known chf, now with acute dyspnea and increased o<num> requirement.
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Pa and lateral chest radiographs were provided. There is no focal consolidation, pleural effusion, pneumothorax, or nodules. The cardiomediastinal silhouette is normal. Bony structures are intact.
<unk>-year-old woman with history of melanoma, please evaluate disease status.
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Left-sided pacemaker device with leads terminating in the right atrium and right ventricle is in unchanged position. There is mild cardiomegaly with a left ventricular predominance. Aortic knob calcifications are re- demonstrated. The pulmonary vasculature is not engorged. Patchy right basilar opacity likely reflects atelectasis. No focal consolidation, pleural effusion or pneumothorax is seen. Multilevel degenerative changes are noted within the mid and lower thoracic spine with bridging anterior osteophytes.
congestive heart failure, recent stent placement, now with hypotension.
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Ap and lateral views of the chest are compared to previous exam from <unk>. Previously identified left-sided picc is no longer seen. The lungs are clear of focal consolidation, effusion, or pulmonary vascular congestion. Cardiomediastinal silhouette is stable, as are the osseous and soft tissue structures.
<unk>-year-old male with history of chf and altered mental status.
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Supine portable ap view of the chest provided. Endotracheal tube is seen with its tip residing approximately <num> cm above the carina. The right chest tube is seen extending medially and reversing its direction as it abuts the mediastinum. A left apically directed chest tube is also seen. There is also a small pigtail chest tube on the right.a nasogastric tube extends into the left upper abdomen. There is diffuse pulmonary edema. No pneumothorax. Cardiomediastinal silhouette is grossly unremarkable. Bony structures are grossly intact.
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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 shoulder pain status post mvc
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Bilateral parenchymal scarring is again identified, most extensive in the right mid lung where there are adjacent chain sutures. There is no new confluent consolidation nor effusion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified.
<unk>f with chest pain // eval infiltrate, effusion, cardiomegaly
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Ap portable upright view of the chest. Evaluation is limited due to motion artifact. Vein ground-glass opacities are noted in the mid to lower lungs which are incompletely characterized or assessed due to motion artifact. No large effusion is seen. Mild left basal atelectasis is noted. Prominence of the pulmonary hila appears new. No pneumothorax. Heart size cannot be assessed. Mediastinal contour is normal. Bony structures are intact.
<unk>-year-old man with fever, dyspnea, cough // r/o infiltrate
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The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.
<unk>f with cough // pna
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The lungs are clear without consolidation. Focal pleural thickening seen at the right lung laterally is unchanged. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities.
<unk>m with wheezing x<num>hrs // asthma exacerbation
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Ap portable upright view of the chest. An endotracheal tube is no longer visualized. The patient is post cabg. Again seen are bilateral pulmonary opacities which are minimally changed since <unk>, reflecting known ards. There is no pneumothorax or large pleural effusion. The heart is mildly enlarged.
<unk> year old man with improving ards still intubated // interval change?
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Opacity projecting over the right mid lung field corresponds to congenital fusion of the right-sided ribs, unchanged. Lung volumes are low which accentuate the size of the cardiac silhouette which appears mildly enlarged. Mediastinal and hilar contours are unremarkable. Crowding of the bronchovascular structures is noted without pulmonary edema. No focal consolidation, pleural effusion or pneumothorax is present. Remote left-sided rib fractures are re- demonstrated. Diffuse idiopathic skeletal hyperostosis is again seen in the thoracic spine.
history: <unk>m with intermittent chest pain and shortness of breath x <num> days
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Exam limited by motion. Lower lung volumes seen on the current exam with secondary crowding of the bronchovascular markings and probable superimposed vascular congestion. There is more confluent opacity in the left mid lung. There is no large effusion. The cardiac silhouette is enlarged but stable. Anterior cervical fixation hardware is visualized. There is asymmetric opacity in the left mid lung
<unk>f with fever // eval pna
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Ap upright and lateral views of the chest provided. There is a dextroscoliosis of the t-spine and the patient is rotated which limits evaluation. Allowing for this, no signs of pneumonia or chf. No effusion or pneumothorax. The heart and the mediastinal contour is unchanged in appearance and size. No bony abnormalities.
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Frontal and lateral views of the chest were obtained. Dual-lead left-sided aicd is again seen with leads extending to the expected positions of the right atrium and right ventricle. No pleural effusion or pneumothorax is seen. Diffusely increased interstitial markings bilaterally, worsened since the prior study, may be due to worsening of chronic interstitial lung disease or acute on chronic process. Slight increase in interstitial markings at the lateral right upper lung may relate to the above process, although atypical infection at this location is not excluded. The cardiac and mediastinal silhouettes are stable and unremarkable. As also noted on the prior study, there is subtle background of increased interstitial markings, which may be due to chronic lung disease.
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Right chest wall port-a-cath is seen with tip in the right atrium. Left chest wall dual lead pacing device is noted. Large right greater than left pleural effusions are noted. Catheter projects over the right lung base with tip projecting adjacent to the spine. Reported left-sided chest tube is faintly visualized but its course cannot be delineated. Suspected tiny biapical pneumothoraces. Cardiac silhouette cannot be assessed. Superiorly the lungs are clear. Osseous structures are unremarkable.
<unk>f with new bilat chest tubes // eval chest tube placement
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Since the prior exam, there is a new chest tube entering the left chest wall with associated subcutaneous air. The tip is at the left base. New surgical chain sutures are noted in the right mid and lower lung zones. There is a tiny right apical pneumothorax. Widespread interstitial abnormalities are unchanged. There is new mild asymmetric left-sided pulmonary edema, likely a consequence of the surgical technique and positioning. There is no pleural effusion. The cardiomediastinal silhouette is normal.
status post vats wedge biopsy. evaluate chest tube placement.
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Heart size is borderline enlarged. Mediastinal. The skull is engorged. Lung volumes are slightly low with patchy atelectasis noted in bases. Focal consolidation pleural effusion or pneumothorax is present. To moderate degenerative changes are noted in the imaged thoracic spine with anterior bridging osteophytes and degenerative changes are also present within the left glenohumeral joint.
history: <unk>m with increasing abdominal girth and jaundice. evaluate for pleural effusion, pneumonia
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The lungs are hyperinflated, consistent with known severe emphysema. There is mild pulmonary edema. There is an increased patchy opacity in the left lung base compared with prior exams, which is concerning for infection. There is a small left-sided pleural effusion, similar to prior exam. The previously seen right pleural effusion has resolved. There is no pneumothorax. There is cardiomegaly, unchanged from prior exam. Surgical clips are seen in the upper mid abdomen.
hypoxia and dyspnea.
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As compared to the previous radiograph, the patient has developed a parenchymal opacity in the right middle lobe that is very unlikely to correspond to pneumonia. The opacity is relatively ill-defined and shows subtle air bronchograms. The opacity is also seen on the lateral radiograph. No other abnormalities. No pleural effusions. No other parenchymal changes. No hilar or mediastinal adenopathy. Normal size of the cardiac silhouette.
cough for <unk> weeks, night sweats, contact with tb, evaluation for pulmonary abnormality.
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Dual lumen central venous catheter tip terminates in the low svc. Cardiac, mediastinal and hilar contours are normal. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormality is visualized.
history: <unk>f with nausea, vomiting, history of cancer
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This patient presented with asymmetric right more than left opacities on <unk> that rapidly deteriorated over a course of two hours. A bronchoscopy was done and found no blood and no mucus plugging. The patient is now treated with pneumonia. On today's exam et tube ends <num> cm above the carina. Ng tube is in the stomach. The severe widespread opacities have worsened at the lung bases and left upper lobe, but improved in right upper lobe. There is possibly adjacent pleural effusions, hard to assess. Mediastinal and cardiac contours are top normal. There is no pneumothorax.
patient with flash pulmonary edema, interval change.
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The cardiac silhouette size is normal. The aorta is mildly tortuous, but unchanged. The mediastinal and hilar contours otherwise are unremarkable. The lungs are clear and the pulmonary vascularity is normal. Again seen is a healed left posterior <num>rd rib fracture. Cervical fusion hardware is partially imaged. Clips in the right upper quadrant the abdomen indicate prior cholecystectomy.
shortness of breath.
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Frontal and lateral views of the chest were obtained. The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema is seen.
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Right lower lobe opacification is again seen but is improving compared to previous chest radiograph. Continued bibasilar small pleural effusions are seen with associated atelectasis. The cardiac silhouette and the mediastinal contours are normal. Mild pulmonary edema continues to be seen. The osseous structures are grossly unremarkable.
<unk>-year-old male with fever, elevated white blood cell count, and increased respiratory rate and absent breath sounds at the right lung base. evaluate for interval change, evaluate for pneumonia.
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There is persistent complete opacification of the left hemithorax with marked volume loss including leftward mediastinal shift. Streaky right upper lobe opacity has decreased, suggesting an atelectasis. Otherwise, the right lung appears clear. There is no right-sided pleural effusion. No pneumothorax is demonstrated. The patient is status post posterior lumbar fusion, incompletely characterized.
prior multiple episodes of pneumonia with shortness of breath and right basilar crackles.
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The tracheostomy tube is again visualized. Ng tube tip is off the film, at least in the stomach. There is a moderate left-sided pleural effusion and volume loss in the left lower lobe. Air bronchograms are visualized and it is likely that an infiltrate is also present in this region. There is pulmonary vascular re-distribution and patchy areas of alveolar infiltrate elsewhere in the lungs. The overall impression is that of chf. Focal infectious infiltrate cannot be excluded, particularly on the left.
status post tracheoplasty, now in trach collar, question atelectasis.
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Right-sided port-a-cath terminates in the cavoatrial junction without evidence of pneumothorax.no focal consolidation is seen. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable.
<unk> year old woman with neutropenic fever // eval for pneumonia
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A portable frontal chest radiograph demonstrates a right chest tube, unchanged in position. There is now a small right apical pneumothorax. Right chest wall subcutaneous emphysema is unchanged. Bibasilar atelectasis is mildly increased. The cardiac silhouette is grossly unchanged. Mild vascular congestion is unchanged. There is no pleural effusion.
evaluate for interval change in a patient with a right chest tube now placed to water seal.
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Since the prior exam, there is an increased right pleural effusion with associated right basilar opacity. Additionally, obscuration of the left costophrenic angle is likely due to a small effusion and atelectasis. There is no overt pulmonary edema. The apices of the lungs are clear. There is no pneumothorax. The mediastinal contour is normal. The heart size is moderately enlarged, and unchanged from prior exams.
history of congestive heart failure with bibasilar crackles and hypotension. evaluate for pulmonary edema or pneumonia.
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Exam is limited due to patient position and low lung volumes. Superior mediastinum and lung apices are obscured. No overt signs of edema or pneumonia. No large effusion or pneumothorax. No gross bony abnormality.
<unk>m with altered mental status // ? mass / bleed
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Frontal and lateral views of the chest were obtained. Dual-lead left-sided pacer device is seen with leads extending to the expected positions of the right atrium and right ventricle. There is no evidence of pneumothorax. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable.
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The lungs are clear. The cardiomediastinal contours are unchanged. No cardiac enlargement. No pleural effusions or pneumothorax. Prior median sternotomy and cabg.
<unk> year old man with brain tumors. // is there a lung primary malignancy?
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The heart size is normal. The hilar mediastinal contours are normal. The lungs are clear without evidence of focal consolidations concerning for pneumonia. There is no pleural effusion or pneumothorax. The visualized osseous structures are unremarkable.
<unk>m with dyspnea, // any pneumonia?
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Frontal and lateral views of the chest demonstrate normal lung volumes. There is no pleural effusion, focal consolidation or pneumothorax. The hilar and mediastinal silhouettes are unchanged. The descending aorta appears tortuous. Linear opacity in the left lung likely represents atelectasis or scarring. Partially imaged upper abdomen is unremarkable.
patient with soft tissue infection. assess for pneumonia.
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Hardware instrumentation of the thoracic spine. Right port-a-cath in place. Worsened left basilar consolidation, likely atelectasis in the setting of worsening moderate left pleural effusion. Increased pulmonary vascularity, more prominent. Heart size difficult to evaluate secondary to consolidation shallow inspiration. .
<unk> year old man with nhl, aaa, likely metastatic prostate cancer here w/ t<num> compression s/p t<num> decompression and t<num>-<unk> now w/ worsening neuro exam and new progressive o<num> requirement // evaluate for consolidation, pulmonary edema,
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Pa and lateral views of the chest provided. Lungs are hyperinflated. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.
<unk>m with intermittent sob, cp
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Frontal and lateral chest radiographs demonstrate clear lungs without effusion or pneumothorax. The cardiac silhouette is normal appearing, with a prominent right cardiophrenic fat pad. The mediastinal contours are unremarkable. Note is made of calcification of the aortic knob. Stable post-kyphoplasty changes of the thoracic spine.
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Heart size is within normal limits. The cardiomediastinal silhouette is unremarkable. Lung fields clear. A right chest port terminates in the low svc.
history: <unk>f with sob and tachycardia. hx of pe // ?pneumonia, pneumothorax, pulmonary edema
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Compared to the study from two days prior. The heart size is mildly larger, but there is no focal infiltrate or effusion. Et tube and ng tube are unchanged.
angioedema, spiking fevers.
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Portable semi-erect radiograph of the chest demonstrates an enteric tube extending below the diaphragm with the tip out of view the inferior aspect on image. Lung volumes are low. Bibasilar opacities may reflect atelectasis; however, infection or aspiration are possible in the correct clinical setting. No pneumothorax. Small left pleural effusion. A rounded rim calcified lesion in the left upper quadrant was demonstrated to be a splenic calcified lesion on the prior ct.
status post exploratory laparotomy and <unk> patch over duodenal perforation. evaluate for interval change.
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The lung volumes are low. There is mild vascular engorgement but no evidence of pulmonary edema. There is no consolidation, pleural effusion, or pneumothorax. Small central calcifications are unchanged and represent known calcified lymph nodes, likely from prior granulomatous disease. There is calcification of the aortic arch. The cardiac size is at the upper limits of normal. No fracture is identified.
history of mechanical fall. evaluate for fracture or dislocation.
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Low lung volumes limits evaluation. Bronchovascular crowding is noted in the lower lungs with mild atelectasis. No convincing evidence for pneumonia or edema. No large effusion or pneumothorax. Cardiomediastinal silhouette is stable. Mediastinal contour is somewhat prominent reflective of an unfolded thoracic aorta. There is mild calcification of the aortic knob. Bony structures are intact. No free air below the right hemidiaphragm.
<unk>m with substernal chest pain, intermittent // wide mediastinum?
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Pa and lateral views of the chest were provided. Midline sternotomy wires and mediastinal clips are again noted. There is known mass at the right lung base which is similar in appearance to prior ct. There is no clear sign of superimposed pneumonia. The heart appears mildly enlarged. The mediastinal contour appears stable from the prior chest radiograph. Bony structures are unchanged.
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In comparison with the earlier study of this date. There is increasing haziness bilaterally consistent with layering pleural effusions with associated compressive atelectasis. Some engorgement of pulmonary vessels is consistent with elevated pulmonary venous pressure. Monitoring and support devices remain in place.
extubation.
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In comparison with study of <unk>, the nasogastric tube has been pushed forward so that the side hole is well passed the esophagogastric junction. The heart and lungs remain within normal limits.
ng tube placement.
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Comparison is made to previous study from <unk>. There is unchanged cardiomegaly. There is persistent atelectasis versus developing infiltrate at the left lung base. This is stable. There are no signs for overt pulmonary edema or pneumothoraces. Overall, there has been no interval change.
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Cardiac, mediastinal and hilar contours are within normal limits. Pulmonary vasculature is normal. Minimal patchy opacities are seen in the lung bases, more so on the left. No focal consolidation, pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.
history: <unk>f with shortness of breath
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Lung volumes are low. Bilateral interstitial opacities are compatible with pulmonary edema. There is no focal consolidation, large pleural effusion or pneumothorax. The heart is moderately enlarged. Sternal closure device is stable.
history of desats to <num>s after iv fluid bolus. assess for pulmonary edema.
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Ap view of the chest provided. The right-sided chest tube has been removed. There may be a tiny right apical pneumothorax. Diffuse bilateral nodular opacifications are unchanged.
<unk> year old woman s/p r vats wedge resection, had chest tube pulled
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Cardiac silhouette size is mildly enlarged but unchanged. The aorta is slightly tortuous but unchanged. Mediastinal and hilar contours are stable. Pulmonary vasculature is normal. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is identified. No acute osseous abnormalities identified.
history: <unk>f with tachycardia and chest pressure
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Lung volumes are low. There is severe right convex scoliosis of the visualized spine, centered in the lower cervical spine. Ill-defined bibasilar opacities may represent atelectasis or aspiration. There is no pleural effusion. No pneumothorax. Mediastinal and hilar contours are stable with unchanged severe tortuosity of the thoracic aorta. Mild cardiomegaly is unchanged.
history: <unk>m with chest pain // ?pna
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There is stable mammilation of the right hemidiaphragm. Bibasilar areas of linear atelectasis are new. There is no pneumothorax. Heart size is at the upper limits of normal. Mediastinal contours are stable. Multiple right upper quadrant surgical clips, as well as to radiopaque stents project over the right upper quadrant. There are no new lytic or sclerotic bone lesions suspicious for metastasis.
<unk> year old woman with cholangiocarcinoma, r/o rib met. cholangiocarcinoma, r/o rib metastases.
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The lungs are clear without consolidation, effusion, or edema. The cardiomediastinal silhouette is normal. No acute osseous abnormalities identified.
<unk>m with leukemia, fever // please eval for pna
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In comparison with the study of <unk>, there again are low lung volumes which accentuate the transverse diameter of the heart and tortuosity of the aorta. There is some indistinctness of pulmonary vessels suggesting elevated pulmonary venous pressure. Blunting of the costophrenic angles is consistent with small effusions and basilar atelectasis. In the appropriate clinical setting, supervening pneumonia would be difficult to exclude.
shortness of breath .
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Endotracheal tube is in place roughly <num> cm cranial to the carina. Heart size is normal. Hilar contours are unremarkable. Calcifications are noted in the aortic knob. There are diffuse, hazy opacities throughout the right lung, lingula and left lower lobe with loss of the left hemidiaphragm border with possible small effusion. There is no pneumothorax.
intubated. evaluate for pneumonia.
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Heart size is mildly enlarged. The aorta is unfolded. There is mild pulmonary edema with small bilateral pleural effusions. Bibasilar airspace opacities likely reflect atelectasis. No pneumothorax is demonstrated. There are no acute osseous abnormalities.
history: <unk>f with chest pain
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In comparison with study of <unk>, the monitoring and support devices remain in place. The tip of the left subclavian catheter is not well seen on this study, though the configuration suggests that it could still well be within the azygous vein. No definite pneumothorax. There is increasing opacification at the right base, worrisome for developing pneumonia. Some hazy opacification at the bases is consistent with bilateral pleural fluid and some atelectatic change. The area of possible opacification in the left mid zone is difficult to assess on this study due to overlying material.
ischemic bowel disease.
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There is no focal consolidation, pleural effusion or pneumothorax. No evidence of pneumomediastinum. Cardiomediastinal silhouette is within normal limits. Mild dextrocurvature of the thoracic spine may be positional.
history: <unk>f with dysphagia s/p egd yesterday and inability to tolerate po // sign of pneumomediastinum or post-procedural changes
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Moderate cardiomegaly is unchanged. The hilar contours are unremarkable. There is a moderate right pleural effusion that is increased from previous studies and has a fissural component similar to study from <unk>. There are no focal abnormalities of left lung.
<unk> year old woman with pleural effusion // eval
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No focal consolidation, pleural effusion, pneumothorax or pulmonary edema is detected. Heart and mediastinal contours are within normal limits.
<unk>-year-old female five months postpartum with leg swelling.
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No evidence of pneumothorax, though this is a semi-upright view. Indeed, there is no evidence of acute cardiopulmonary disease. If demonstration of a small pneumothorax would be clinically important, ct could be obtained.
possible pneumothorax seen on kub.
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Mild cardiomegaly is re- demonstrated. Mediastinal and hilar contours are grossly unremarkable allowing for patient rotation. There has been interval improvement in degree of pulmonary edema, now with only mild pulmonary vascular congestion noted. Lungs remain hyperinflated. No focal consolidation, pleural effusion or pneumothorax is present. There is minimal degenerative change within the thoracic spine.
history: <unk>f with word finding difficulty
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Since <unk>, new mild asymmetric pulmonary edema, right greater than left, is superimposed on the known chronic lung disease. Mild bibasilar atelectasis is noted. A small left pleural effusion is possible. The heart is mildly enlarged. Median sternotomy wires are intact and aligned. No pneumothorax. Partially imaged spinal fusion hardware is identified in the lumbar spine.
<unk> year old woman with fall, cad s/p cabg crackles one exam. // etiology of crackles
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The lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are stable. Partially imaged is hardware in the lower cervical spine.
history: <unk>m with cp // r/o pna
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The heart is normal in size. The mediastinal and hilar contours appear within normal limits. The lungs appear clear. There are no pleural effusions or pneumothorax. Bony structures appear within normal limits.
inspiratory chest pain. history of marijuana.
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Comparison is made to the prior radiographs from <unk>. There is a right-sided picc line with distal lead tip at the distal svc, stable. Heart size is within normal limits. Lungs are grossly clear aside from some increased density in the left retrocardiac area. There are no signs for overt pulmonary edema. No pneumothoraces are present. A pigtail catheter is seen overlying the lower heart border.
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Pa and lateral chest radiographs. There is no focal consolidation, pleural effusion, or pneumothorax. The heart size is normal.
fever and chills.
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The heart size is normal. Mediastinal and hilar contours are unremarkable. The pulmonary vascularity is normal. Lungs are clear. No focal consolidation, pleural effusion or pneumothorax is present. No acute osseous abnormalities detected.
chest pain.
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In comparison with study of <unk>, there has been placement of an orogastric tube that is coiled within the fundus of the stomach. Otherwise, little change.
ogt placement.
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Right chest wall dual lead venous catheter seen with distal tip in the right atrium. Left-sided picc is seen to cross the midline with tip projecting superiorly to the region of the lower right internal jugular vein. There are small to moderate bilateral pleural effusions and bibasilar atelectasis. Cardiac silhouette is mildly enlarged. No acute osseous abnormalities. Chronic appearing bilateral posterior rib fractures are noted.
<unk>m with picc line pls eval position // picc line pls eval position
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Portable semi-upright radiograph of the chest demonstrates a right lower lobe consolidation. Within the right upper lobe there is slight increased opacification, which may represent pneumonia or mass. The lungs are hyperexpanded. Cardiomediastinal and hilar contours are unchanged. No pneumothorax.
history: <unk>f with hypoxia // eval for ptx
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Pa and lateral views of the chest provided. Bronchovascular crowding in the lower lungs results and mildly increased of opacity of the lung markings. There is no convincing evidence for pneumonia edema, effusion or pneumothorax. Cardiomediastinal silhouette is stable. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.
<unk>f with persistent cough // pna
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Heart size is normal. The aorta remains tortuous but unchanged. Mediastinal and hilar contours are unchanged with a small hiatal hernia again noted. Pulmonary vasculature is not engorged. No focal consolidation, pleural effusion or pneumothorax is present. Minimal retrocardiac opacity likely reflects atelectasis. There are hypertrophic changes again seen throughout the thoracic spine.
history: <unk>f with symptomatic cholelithiasis // pre-op
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Low lung volumes with bibasilar atelectasis. No evidence of pneumonia.the cardiac, hilar and mediastinal contours are normal.no pleural abnormality is seen.
<unk>m with fever, ha, cough, + ivdu. evaluate for septic emboli.
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Blunting of left costophrenic angle is unchanged since <unk> and may be due to scarring. The lungs are clear without focal opacity. There is no pneumothorax. The cardiac and mediastinal contours are normal.
<unk>-year-old woman with pleuritic chest pain after smoking crack. evaluate for pneumothorax.
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In comparison with the study of <unk>, there is little overall change. Opacification at the right base medially most likely reflects crowding of vessels. However, in the appropriate clinical setting, the possibility of supervening pneumonia would be difficult to exclude. There is still a huge amount of free intraperitoneal gas. If there is any clinical suspicion for ruptured viscus, additional cross-sectional imaging could be obtained.
aspiration.
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As compared to the previous radiograph, the right internal jugular vein catheter has been pulled back. The tip of the catheter now projects over the mid to lower svc. There is no evidence of complications, notably no pneumothorax. The other monitoring and support devices are unchanged. Unchanged radiographic appearance of the lungs and the heart.
assessment of central venous access line.
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Et tube terminates <num> cm from the carina. Enteric tube terminates in the stomach. Lung volumes are low. There is left lower lobe collapse and consolidation of the right base. Bibasilar consolidations better seen on ct are worrisome for aspiration. The heart is not enlarged. There is no mediastinal widening. There is no large pneumothorax, however the lung apices are excluded from view. Known right upper rib fractures are not seen on this study.
history: <unk>f s/p fall down a flight of stairs // acute injuries
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A left-sided pacemaker is in place. Nasogastric tube enters the stomach. A right-sided picc line has been repositioned, and now terminates in the lower svc. There is no pneumothorax. The lungs are clear.
<unk> year old man with new ngt // ngt
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The tip of the right-sided picc line is at the cavoatrial junction. The endotracheal tube is <num> cm from the carina and the nasogastric tube is in similar position. The right lower lobe atelectasis has improved. The left lower lobe atelectasis is stable. A trace left-sided effusion seen. The pulmonary vascular congestion persists.
<unk> year old female with a history of etoh cirrhosis, iph in <unk> resulting in seizure disorder, dysarthria, left hemiparesis and <unk> nerve palsy, afib, and c-diff, who presented to the ed with two generalized seizures and required intubation for airway protection. // et tube placement, interval change