Frontal_Image_Path
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Portable semi-upright radiograph of the chest demonstrates low lung volumes, which results in bronchovascular crowding. There has been interval removal of the endotracheal tube, nasogastric tube, two mediastinal drainage catheters, and epicardial pacing wires. The cardiac portion of the mediastinum is moderately larger and a much larger triangular gas and debris collection projecting over the left lower lobe bronchus could be in the stomach, esophagus, mediastinum or pericardium. . The left hemidiaphragm is asymmetrically elevated. There is some left lower lobe atelectasis. No pneumothorax.
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<unk> year old woman s/p mvr // eval for pneumo s/p ct removal
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In comparison with study of <unk>, there is little overall change. Tracheostomy tube and central catheter remain in place. Bibasilar opacification is consistent with volume loss and pleural effusion. Continued moderate enlargement of the cardiac silhouette.
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cirrhosis with arrest and anoxic brain injury, to assess for tracheostomy tube.
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Moderate enlargement of the cardiac silhouette is re- demonstrated. The aorta is tortuous but unchanged. Mediastinal and hilar contours are similar. Pulmonary vasculature is normal. Minimal patchy opacity is seen in the retrocardiac region. No focal consolidation, pleural effusion or pneumothorax is present. Moderate multilevel degenerative changes are seen in the thoracic spine. Gastric lap band is incompletely imaged.
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history: <unk>m with <num> month history of productive cough
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Single supine view of the chest. Linear left basilar opacity is likely due to atelectasis. Elsewhere, the lungs are clear. There is no evidence of a large pneumothorax based on the supine film. The cardiomediastinal silhouette is stable. No displaced fractures identified based on this non-dedicated exams. Median sternotomy wires are again noted as well as an aortic valve replacement. Deviation of the trachea to the right at the thoracic inlet is compatible with left-sided thyroid enlargement as seen on prior ct chest.
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<unk>-year-old female with past medical history of aortic stenosis, status post avr, who presents after unwitnessed fall and head strike.
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Left cardiac pacemaker with intact leads ending in the right atrium and right ventricle is seen. Heart size is upper limit of normal with no signs of pleural effusion or pulmonary congestion. No focal consolidation is seen, and no complications of the procedure including pneumothorax are seen.
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<unk>-year-old man with new pacemaker, evaluate lead position.
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The lungs are clear without focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal.
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history of epigastric pain, question pneumonia.
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Pa and lateral views of the chest are obtained. The previously identified cardiomegaly and elongated and tortuous aorta are again demonstrated and are unchanged since the prior study. There is no evidence of focal consolidation, pleural effusion or significant pulmonary edema.
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<unk>-year-old female with left anterior chest wall discomfort. evaluation for pulmonary pathology.
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Portable ap upright view of the chest was reviewed. A left subclavian line ends in the upper right atrium and if pulled back <num> cm would end at the cavoatrial junction. A focal opacity measuring <num> mm located over the <unk> left posterior rib is most likley a bone island; othwerise, the lungs are clear without focal consolidation, pulmonary edema, pleural effusion or pneumothorax. The cardiac and mediastinal contours are normal.
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evaluation of line placement.
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Right chest tube remains in place, with persistent small right apical hydropneumothorax. Surgical clips are again demonstrated consistent with wedge resection site. Slight worsening of heterogeneous opacities in right lung, which may reflect asymmetrical edema or infection. Small dependent pleural effusions are similar, right greater than left.
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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.
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chest pain and fatigue.
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No focal consolidation or pneumothorax is seen. There is blunting of the right costophrenic angle. Heart and mediastinal contours are within normal limits.
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<unk>-year-old female with cough, chest pain, and history of pulmonary embolus.
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The lungs are well expanded and clear. The cardiomediastinal silhouette, hilar contours, pleural surfaces are normal. There is no pleural effusion or pneumothorax. Mild anterior wedging of a mid thoracic vertebral body is better evaluated on concurrent t-spine radiograph.
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status post mvc with t-spine tenderness. evaluate for pneumothorax.
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There is mild pulmonary vascular congestion along with cardiomegaly, suggesting pulmonary edema. No definite pleural effusion is seen. The stomach is distended. There is no focal consolidation or pneumothorax.
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acute hypotension and hypoxemia.
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The lung volumes are normal. Normal size of the cardiac silhouette. Extensive aortic calcification and tortuosity. Minimal obviously fibrotic changes in the retrocardiac lung areas, but no evidence of acute lung disease such as pneumonia or pulmonary edema. No lung nodules or masses. Minimal symmetrically bilateral apical thickening.
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preoperative chest x-ray for hip replacement.
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Pa and lateral views of the chest demonstrate interval resolution of right lung base opacity since the prior study. There remains a small amount of atelectasis in the left lung base. Otherwise, the lungs are clear with no sign of pleural effusion, pulmonary edema, pneumothorax or focal consolidation concerning for pneumonia. The heart size is mildly enlarged, as before. The mediastinal contours are unremarkable.
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<unk>-year-old male with diaphoresis. evaluation for acute process.
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The heart size is moderately enlarged but unchanged. Mediastinal and hilar contours are stable. The pulmonary vasculature is not engorged. Minimal patchy opacity in the left lung base may reflect atelectasis though infection is not completely excluded. No pleural effusion or pneumothorax is visualized. There are no acute osseous abnormalities.
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atrial fibrillation with rapid ventricular rate, congestive heart failure, hiv, worsening dyspnea on exertion over the last month.
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The entire right hemithorax is opacified, largely due to pleural effusion, but there is also a component of underlying pulmonary edema and atelectasis. This is a dramatic change compared to the prior radiograph performed yesterday evening, which suggests re-expansion pulmonary edema. The left lung is essentially clear. There is no pneumothorax. Left heart border is unremarkable. No acute osseous abnormalities. The vp shunt is unchanged in position.
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<unk> year old man s/p right thoracentesis with subsequent hypoxemia. // eval for change in right lung field - ? re-expansion pulm edema
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Two frontal images of the chest demonstrate interval redevelopment of a right-sided pleural effusion. The effusion forms an air-fluid level, suggesting persistent pneumothorax, even though pneumothroax was less conspicuous on previous exam than on the post-procedure exam. There is interval worsening of the right lung base opacity, consistent with the reaccumulating right pleural effusion. The large left pleural effusion remains unchanged from prior imaging. The right-sided picc line and pacer wires are again noted in the expected course, unchanged from previous imaging. Cardiomediastinal silhouette can again not be characterized given obscuration by bilateral pleural effusions.
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<unk>-year-old female with as, cad, and b-cell lymphoma status post right thoracentesis yesterday, now requiring assessment for interval change.
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As compared to the previous radiograph, there is minimally increasing right pleural effusion. Otherwise, the radiograph is unchanged. Bilateral chest tubes and other monitoring and support devices are in constant position. Unchanged size of the cardiac silhouette. No evidence of pneumothorax.
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polytrauma, evaluation for pneumothorax.
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Mild bibasilar atelectasis is seen. There is no focal consolidation. No pleural effusion or pneumothorax. The cardiac silhouette is top-normal. Mediastinal contours are unremarkable. Degenerative changes are noted at the right acromioclavicular and glenohumeral joints. Dish is seen along the thoracic spine.
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history: <unk>m with xfer for gallstone pancreatitis // acute process, pre-op
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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.
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<unk>m with cp
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In comparison with the earlier study of this date, the suspected area of increased opacification in the right mid zone is not definitely present. There is continued enlargement of the cardiac silhouette with evidence of vascular congestion and probable bibasilar atelectasis and possible small effusions. Monitoring and support devices remain in place.
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question opacity on chest radiograph with a new white blood cell count elevation.
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The right picc line tip projects in the region of the cavoatrial junction. There is no focal consolidation, pleural effusion, or pneumothorax. Cardiomediastinal silhouette is unremarkable.
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<unk>m with presyncope. evaluate for infection.
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Pa and lateral chest radiographs were provided. There is no focal consolidation, pleural effusion or pneumothorax. The cardiomediastinal silhouette is normal. Bones are intact.
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syncope. evaluate for cardiopulmonary disease or infiltrate.
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A left internal jugular dialysis catheter terminates in the distal svc. A right internal jugular temporary pacing wire is in appropriate position, the tip appears to be in the right ventricle. There is a persistent right pleural effusion. Hazy opacity throughout the right lung is likely due to layering of the pleural effusion, difficult to exclude underlying consolidation. There is moderate pulmonary vascular congestion, similar in appearance when compared to the prior study.
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<unk> year old woman s/p temp hd line and temp wire from bilateral ijs // eval for interval change
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As compared to the previous radiograph, the left pleural effusion with subsequent parenchymal opacities is unchanged. On the right, there is minimal blunting of the costophrenic sinus, but no larger effusion is identified. Despite the nasogastric tube, the stomach is overinflated. Unchanged mild fluid overload and moderate cardiomegaly. No newly occurred parenchymal opacities.
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decreased mental status, had right pleural effusion, evaluation for right pleural effusion.
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Bibasilar opacities, linear on the right and nodular on the left, may represent pneumonia in the appropriate clinical setting, or atelectasis. Cardiomediastinal silhouette is normal. No pleural abnormality is seen. No large pleural effusions.
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hypoxia. evaluate for pneumonia.
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Frontal and lateral views of the chest. The lungs are clear. There is no effusion nor pneumothorax. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormality detected.
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<unk>-year-old female with substernal chest pressure.
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In comparison with the study of <unk>, there is little change in the appearance of the cardiac silhouette and the lungs. Again there is evidence of increased pulmonary venous pressure. No definite consolidation, though in the appropriate clinical setting and pneumonia at the base, especially on the right, would have to be considered.
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acute shortness of breath and worsening crackles, to assess for worsening pulmonary edema.
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There has been interval decrease in pulmonary vascular congestion with improved aeration and lung volumes. No pleural effusion, edema, or pneumothorax is seen. Ng tube is seen coursing through the esophagus entering the stomach and then out of field of view. Endotracheal tube is appropriately positioned terminating no less than <num> cm from the carina.
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<unk>-year-old male intubated after recent spine surgery.
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Few linear bands of atelectasis or scarring in the lower lungs are similar. Normal heart size, pulmonary vascularity. No pleural effusions.
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<unk> year old woman with hcc and cirrhosis with worsening mental status and evidence of hepatic encephalopathy // please evaluate for evidence of pneumonia
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Pa and lateral views of the chest were provided demonstrating clear well-expanded lungs without pleural effusion, pneumothorax, focal consolidation or signs of pulmonary edema. Heart size is stable and top normal. The mediastinal contour appears normal. Bony structures are intact.
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<unk>-year-old female with had strike, syncope.
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The lungs are well expanded. A previously seen right lower lobe opacity has resolved in the interval. Obscuration of the right hemidiaphragm margin may be secondary to a combination of small pleural effusion with associated right basilar fibrosis/atelectasis. No focal opacities concerning for pneumonia are seen. Moderate cardiomegaly is unchanged. There is no pneumothorax. Sternotomy wires are intact. Prosthetic aortic valve is better seen in the lateral view.
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<unk>-year-old male with fall change in mental status anticoagulated for artificial aortic valve. evaluate for pneumonia.
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Single ap upright view of the chest provided. Lungs are clear. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm. Left cp angle partially excluded. No large effusion is seen.
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There has been interval improved aeration bilaterally. The heart continues to be moderately enlarged but is less prominent compared to the prior exam. There continues to be bilateral lower lobe volume loss and elevation of the left hemidiaphragm and small left pleural effusion. The left subclavian line is unchanged
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<num>g w/ lepitic type adenoca in lul, no evidence of lymphadenopathy or metastases s/p robotic-assisted converted to l thoracotomy, l upper segmentectomy c/b l pa injury s/p chest tube pull // interval changes
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The cardiac silhouette size is normal. The aorta remains tortuous. The mediastinal and hilar contours otherwise are unremarkable. Lungs are clear and the pulmonary vascularity is normal. Biapical scarring is unchanged. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities.
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weakness.
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Frontal and lateral views of the chest were obtained. There is subtle left basilar opacity which could be due to atelectasis; however, infection process is not excluded in appropriate clinical setting. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are unremarkable. No pulmonary edema.
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Persistent cardiomegaly and pulmonary vascular congestion accompanied by increasing, but mild interstitial edema. A more confluent opacity in the left lower lobe has slightly improved with improved visualization of the medial and lateral left hemidiaphragm contours. Adjacent small pleural effusion is also demonstrated. Within the right lung, multifocal nodular opacities correspond to known lung nodules on prior ct of the chest <unk> <unk>, and note is also made of a small right pleural effusion.
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Lung volumes are low with secondary crowding of the bronchovascular markings. The lungs appear clear. The cardiomediastinal silhouette is within normal limits. Surgical clips project over the lower neck bilaterally. No acute osseous abnormalities.
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<unk>f with back pain and fever // r/o pna
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Frontal and lateral views of the chest demonstrate dialysis catheter in the right atrium. Pacemaker lead projects over right ventricle and right atrium. Moderate left pleural effusion is present. Small right pleural effusion cannot be excluded. Prominent round opacity in the left hilum reflects left pulmonary artery, better seen on the most recent ct. Heart size is normal. Bibasilar opacities likely reflect atelectasis. No pneumothorax.
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patient with history of hypertension, end-stage renal disease, who presents for trial of dialysis. assess for intrathoracic pathology.
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Heart size, mediastinal and hilar contours are within normal limits and without change. Mild paramediastinal bilateral upper lobe scarring is present without change from prior studies. Lung volumes are lower compared to the prior study with some associated crowding of bronchovascular structures in the lower lungs. Hyperlucency of upper lungs is consistent with known emphysema. No definite areas of consolidation are identified to suggest pneumonia, but repeat radiograph with improved inspiratory level may be helpful to more fully assess the lung bases if warranted clinically.
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Compared to <unk>, there is no significant change. Again seen is left basal opacity and pleural effusion, not significantly changed compared to prior. The left lung is mostly clear. The cardiac and mediastinal silhouettes are unchanged.
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<unk> year old man with cirrhosis and new o<num> req // ?consolidation
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Evaluation of the cardiac silhouette is somewhat limited due to overlying soft tissues. There is probably mild enlargement of the cardiac silhouette. As compared to prior examination, pulmonary markings are increased, felt to reflect mild pulmonary vascular congestion. Blunting of the left costophrenic angle could reflect a small amount of pleural fluid. No focal consolidation concerning for pneumonia there is no pneumothorax.
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history: <unk>f with sob // infiltrate? edema? infiltrate? edema?
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Pa and lateral chest radiographs. The lungs are clear. There is no pleural effusion or pneumothorax. The thoracic aorta is tortuous and stable from <unk>. The cardiomediastinal silhouette is otherwise normal.
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chest pain and intoxication.
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Pa and lateral views of the chest were provided. Epicardial pacing leads are noted. There is no overt chf, pneumonia, pleural effusion, or pneumothorax. Heart size is top normal. Mediastinal contour is normal. Bony structures are intact.
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There is slight elevation of the right hemidiaphragm, unchanged from the prior study. The lungs are clear bilaterally. There is no pneumothorax, pleural effusion, pulmonary edema, or focal consolidation. The cardiomediastinal silhouette is unremarkable.
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history: <unk>m with severe respiratory distress // acute process
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Rotated positioning. An ng tube is present --<unk> tip extends beneath the diaphragm and overlies the expected site of the gastric fundus, beyond the ge junction. Cardiomediastinal silhouette is unchanged. No focal consolidation, overt chf, or gross effusion is identified. Minimal blunting of the left costophrenic angle cannot be entirely excluded. There is linear bibasilar linear atelectasis. The <num> mm nodule identified on the <unk> chest ct in the right lower lobe is not definitively identified on this examination, presumably due to limitations of the modality. No free air seen beneath the diaphragms. Incidental note is made of osteopenia, scoliosis and degenerative change the thoracic and upper lumbar spine, with mild endplate scalloping of at least two mid thoracic vertebral bodies and of severe degenerative changes of the left glenohumeral joint.
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<unk> year old woman with sbo s/p ngt placement // confirm ng location
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The lungs are hyperinflated, compatible with copd. Mild bibasilar atelectasis is present. Calcified apical pleural thickening and scattered calcified pulmonary nodules are stable consistent with prior granulomatous infection. There is no pleural effusion, pulmonary edema, or focal airspace consolidation. A left chest wall pulse generator device, with pacemaker leads in the right atrium and right ventricle are unchanged. Multiple healed right-sided rib deformities and compression deformities in the thoracic spine are unchanged.
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history: <unk>f with fall with unknown circumstances, ?syncope? // r/o fracture, ich, pna
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One portable ap upright two view of the chest. Hyperinflation is consistent with copd, likely emphysema. Previously seen small bilateral pleural effusions have significantly decreased. The heart size is top normal. The mediastinal contours are unchanged. There are aortic calcifications. There are right upper, left upper, and right lower lobe consolidations, similar to prior study.
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shortness of breath, evaluate for infiltrate of pulmonary edema.
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Pa and lateral views of the chest. No prior. There is eventration of the right hemidiaphragm. The lungs are grossly clear without effusion or pneumothorax. Cardiac silhouette is enlarged. Ossific density projects over the right neck. Soft tissues are otherwise unremarkable. Degenerative changes noted at the left glenohumeral joint. Multiple surgical clips project over the upper abdomen.
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<unk>-year-old male with question pneumonia, altered mental status.
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Compared with the prior chest radiograph performed two days ago, the lung volumes have markedly decreased. Linear bilateral lower lobe opacities correspond to scarring and atelectasis on the prior chest ct. A oval nodule projection of the right lung which corresponds to a granuloma. No new focal opacity concerning for pneumonia or aspiration identified. There is no pulmonary edema. The cardiac and mediastinal contours are stable.
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<unk> year old man with new dyspnea, tachypnea // eval for edema, pneumothorax
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The left picc tip remains within the lower svc. Tracheostomy tube is unchanged in position. Patient is status post median sternotomy, aortic and mitral valve replacement, and cabg. Moderate cardiomegaly persists, and diffuse atherosclerotic calcifications of the thoracic aorta are noted. Mediastinal contour is relatively unchanged with central venous vascular congestion. There is mild to moderate pulmonary edema, not substantially changed considering differences in positioning. Hazy opacification in the right lung is compatible with a layering right pleural effusion, likely small to moderate in size. There is likely a trace left pleural effusion as well. Patchy opacities in lung bases may reflect areas of atelectasis. No large pneumothorax is detected on this supine exam.
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history: <unk>f with tracheostomy, respiratory distress
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In comparison with the study of <unk>, there is little interval change. Cardiac silhouette is at the upper limits of normal or mildly enlarged. No vascular congestion, pleural effusion, or acute focal pneumonia.
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chest pain, to assess for pneumonia.
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Relatively low lung volumes are noted. The lungs are clear without consolidation, effusion, or vascular congestion. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified.
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<unk>f with code stroke // r/o infection
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As compared to the previous examination, there is no substantial change in position of the endotracheal tube. The tip of the tube currently projects <num> cm above the carina and is located relatively high. Advancement by <num>-<num> cm appears possible. Better delineated than on the previous examination are the multiple pleural calcifications. The left medial component of these calcifications mimics the presence of a pneumothorax (no pneumothorax is clearly visible on the present examination). Unchanged distribution and extent of the pre-existing parenchymal opacities. Unchanged size of the cardiac silhouette.
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endotracheal tube placement.
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Frontal radiograph of the chest demonstrates interval placement of et tube in standard position with distal tip <num> cm above the level of the carina. There has been mild interval worsening of the left basilar opacification, likely representing consolidation as well as mild interval worsening of the right basilar opacification, which likely represents pleural fluid. Esophageal feeding tube is seen in standard position below the level of the diaphragm with distal tip in the proximal stomach. Two pigtail catheters are seen projecting over the left and right mid abdomen, respectively the previously demonstrated pulmonary edema and cardiomegaly are unchanged on this exam. There is no pneumothorax.
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<unk>-year-old female with copd and new ett placement. new og tube placement.
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Since prior, there has been increased blunting of the left and right costophrenic angles, consistent with small bilateral pleural effusions. Additionally, increased heart size and peribronchial cuffing suggests mild pulmonary edema. A new linear opacity in the right midlung is likely infectious. There is no pneumothorax.
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<unk> year old woman with acute shortness of breath and crackles on exam, had been admitted for copd exacberation, evaluate for pulmonary edema.
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An esophageal catheter terminates in the stomach, which appears distended. The lung fields demonstrate no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. Heart and mediastinal contours are within normal limits.
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<unk>-year-old female with small bowel obstruction status post nasogastric tube placement.
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Kyphosis due to renal osteodystrophy simulates increased ap diameter of the chest. In the recurrently collapsed left lower lobe there is only mild subsegmental atelectasis. There is no consolidation of pleural effusion. Heart size is top normal. There is no pulmonary edema.
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cough and fever.
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Since <unk>, there is a new right pneumothorax. The right pleural effusion has increased in size and is now mild to moderate. Worsening bibasilar atelectasis. Diffuse airspace opacities bilaterally with unchanged persistent cardiomegaly likely consistent with mild pulmonary edema.
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<unk> year old woman s/p rll upper segmentectomy still requiring high flow o<num> // interval change s/p aggress chest pt, nebs
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Pa and lateral views of the chest provided. The lungs are clear. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is unchanged with prominence of the mediastinum likely due to a ectatic vasculature., unchanged from prior. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.
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<unk>m with resolved rue and right facial weakness <num> days ago
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The lungs are well expanded. There is a focal opacity with convex margins along the right lateral hemithorax concerning for a pleural based lesion. There is mild elevation of the left hemidiaphragm, with linear densities across the left lower lung field as well as more patchy opacification in the left lower lobe. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax.
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<unk>-year-old male with decreased breath sounds in the left lower lobe. evaluate for evidence of pneumonia or effusion.
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The cardiomediastinal and hilar contours are within normal limits. Lungs are well expanded and clear. There is no focal consolidation, pleural effusion or pneumothorax.
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history: <unk>m with cough/thoracic back pain // r/o acute process r/o acute process
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As compared to the previous radiograph, there is a minimal increase in extent of the pre-existing right pleural effusion and constant appearance of the rather extensive left pleural effusion. Moreover, areas of atelectasis caused by the effusion have slightly increased in extent. Massive cardiomegaly persists. Mild pulmonary edema is unchanged.
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bilateral pleural effusions, chronic heart failure, evaluation.
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Cardiomediastinal contours are stable with widening of the mediastinum and moderate to severe cardiomegaly. Pulmonary edema has markedly improved. There is no pneumothorax. Bilateral effusions have decreased now very small. Sternal wires are aligned
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<unk> year old woman with s/p mvr/tvr/asd closure // eval post op changes
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In comparison with the study of <unk>, there is again enlargement of the cardiac silhouette with some indistinctness of engorged pulmonary vessels consistent with elevated pulmonary venous pressure. Continued opacification at the right base is consistent with pleural effusion and atelectasis. Less prominent atelectasis and effusion may well be present on the left.
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hypoxia and cough.
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Ap upright and lateral views of the chest were provided. Bilateral pleural effusions are again noted without significant change from prior exam. There is pulmonary vascular congestion with interstitial edema noted. The heart size appears grossly stable. No pneumothorax. Bony structures appear grossly intact.
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Pa and lateral views of the chest. No prior. The lungs are clear. There is no effusion or pneumothorax. The cardiomediastinal silhouette is normal. Osseous and soft tissue structures are unremarkable.
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<unk>-year-old male with chest pain, worse with activity.
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Ap and lateral views of the chest were obtained. No focal consolidation, pleural effusion, or evidence of pneumothorax is seen. The cardiac silhouette is top normal, unchanged. The aortic knob is calcified. There has been interval removal of the right-sided hemodialysis catheter. No overt pulmonary edema is seen.
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An et tube is approximately <num> cm from the carina. A right subclavian central line is seen in the lower svc. On the most recent prior radiograph, there is no significant interval change. Hazy opacification bilaterally in the lower lung zones may represent a combination of fluid and atelectasis. There is no definite focal consolidation or pneumothorax. Ng tube is seen below the diaphragm.
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<unk>-year-old woman status post bicycle accident with polytrauma, assess for interval change.
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Pa and lateral views of the chest provided. Midline sternotomy wires again noted. Cardiomediastinal silhouette is unchanged with mild cardiac enlargement. Aortic and mitral valve replacements are noted. Lungs are clear without overt signs of edema or pneumonia. Mild hilar congestion is suspected. No large effusion or pneumothorax. Bony structures are intact. Degenerative changes of the left shoulder partially imaged
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<unk>m with chest pain and doe, hx of copd
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In comparison to <unk> study the large left pleural effusion has increased in size. No focal consolidations, pulmonary edema, or pneumothorax are seen.
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<unk> year old woman with post cabg pleural effusion. // please evaluate change of pleural effusion
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In comparison with the study of <unk>, the outermost portion of the left hemithorax has been excluded from the image. Again, there are low lung volumes with bibasilar atelectatic changes. No definite pneumonia. Central catheter remains in unchanged position with possible kink in its most proximal portion. The proximal humerus on the right is visualized on this study and shows some amorphous calcifications, which could represent old healed bone infarct or even an enchondroma.
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aspiration, to assess for consolidation.
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Frontal and lateral views of the chest were obtained. There are relatively low lung volumes. Mild bibasilar atelectasis is seen. There is minimal blunting of the left posterior costophrenic angle which may be due to a trace effusion. No focal consolidation or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable.
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The right costophrenic angle not fully included on the image. Given this, there is likely chronic blunting of the right costophrenic angle. The patient is status post median sternotomy and cabg. The cardiac and mediastinal silhouettes are stable. Patient is status post esophagectomy. Previously seen tiny right apical pneumothorax is better seen on the prior study, however, on the current study there is a lead overlying the right lung apex. Left basilar atelectasis/ scarring is noted. There is minimal to no interstitial edema.
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history: <unk>m with chf, gib s/p <num>u prbcs // evaluate for fluid overload
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The endotracheal tube tip remains low lying, terminating approximately <num> cm from the carina. An enteric tube remains in unchanged position. Left sided chest tube remains with associated subcutaneous emphysema in the left lateral chest wall, with previously noted kinking of the distal aspect of the tube now resolved. Known small left pneumothorax appears grossly unchanged. Aeration of the left lung base also appears slightly improved reflecting day combination of atelectasis and pleural effusion. Multiple left-sided rib fractures are again noted. Remainder of the examination is otherwise unchanged. There is no rightward shift of mediastinal structures.
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history: <unk>f with hypotension, trauma
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Cardiomediastinal and hilar contours are stable. Widespread parenchymal opacities have slightly worsened since the most recent prior study, which again could reflect a combination of pulmonary edema and/or pneumonia superimposed on chronic interstitial lung disease. There is no pneumothorax.
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assess for interval change.
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Comparison is made to previous study from <unk>. There is again seen a right ij central line with distal lead tip in the right atrium. This could be pulled back <num> cm for more optimal placement. The heart size is within normal limits. There are again seen diffuse airspace opacities bilaterally and prominence of the pulmonary interstitial markings which are stable. There are no pneumothoraces. The endotracheal tube and the enteric tube are unchanged in position.
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Left-sided port-a-cath is in adequate position, ending in mid svc. There is no kinking. The proximal portion the line on neck ct was in adequate position. The lungs are otherwise clear. Mediastinal contours are normal. There is no pneumothorax or pleural effusion.
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patient with left-sided port-a-cath. difficulty drawing back, evaluation for port-a-cath placement.
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Again noted punctate small calcific nodules as also noted in the prior study. No focal consolidation, pleural effusion or pneumothorax is seen. The cardiac and mediastinal silhouettes are unremarkable.
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history: <unk>f with sob // eval for infiltrate
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Frontal and lateral views of the chest. The lungs are clear of focal consolidation, effusion, or frank pulmonary edema. There is mild pulmonary vascular congestion. Degree of cardiomegaly has not changed. No acute osseous abnormalities.
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<unk>-year-old male with chest pain. question edema.
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Frontal and lateral chest radiographs demonstrate minimal right basilar linear atelectasis, with otherwise clear lungs. The cardiac silhouette is notable for a prominent epicardial fat. The retrosternal clear space is opacified, which may be due to prominent mediastinal fat although lymphadenopathy or mass could also have this appearance. A nerve stimulator device is noted. The pulmonary vasculature is normal.
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<unk>-year-old male with history of smoking, complaining of dyspnea on exertion.
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The lungs are clear. The cardiomediastinal silhouette is within normal limits. Stent in the trachea and likely bilateral mainstem bronchi was better seen on prior exam. No acute osseous abnormalities.
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<unk>f with shortness of breath, recent trach stent placement // eval for pneumonia, mucous plugging
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Lung volumes are low. Worsening opacity in the posterior basilar segment of the left lower lobe. The heart is top-normal in size. Mediastinal contours and hila are normal. No pleural effusion.
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<unk> year old man with cad, dm<num>, hld, htn with nstemi and pna // interval change, please evaluate for pneumonia and edema
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Bibasilar haze likely reflects known pleural effusion; underlying bibasilar densities are non-specific and may represent atelectasis, but infection cannot be excluded. Lung volumes are low. There is mild interstitial edema. Lobular mediastinal densities likely correspond to lymphadenopathy seen on prior ct and appears progressed. Heart size is top normal. No pneumothorax is detected on this view. Large left upper lobe nodular opacity is again noted and likely corresponds to known metastatic mass. Right-sided hemodialysis catheter is seen with tip possibly terminating within the right atrium, although not well evaluated on this study.
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<unk>-year-old male with hypoxia and altered mental status.
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Pa and lateral chest radiographs were obtained. The lungs are well expanded and clear. There is no focal scarring in the right upper lobe is unchanged. Posterior rib deformities are stable. There is no consolidation effusion or pneumothorax. Cardiac and mediastinal contours are normal. There is no pneumoperitoneum.
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abdominal pain.
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Heart size is normal. The aorta remains tortuous but unchanged. Mediastinal and hilar contours are otherwise unremarkable. Pulmonary vasculature is normal. Streaky opacities in the lower lobes bilaterally likely reflect atelectasis. No focal consolidation, pleural effusion or pneumothorax is seen. Posterior fusion hardware is seen spanning the thoracolumbar junction.
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history: <unk>m with lightheadedness/dizziness
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Review of the report from <unk> cardiac mri indicates that the the patient is status post repair of aortic coarctation with an apparent duplicated svc including a left svc. This likely accounts for the atypical cardiomediastinal contours, which are unchanged compared with <unk>. Again seen is mild diffuse prominence of the pulmonary vessels. There is a slightly nodular appearance the vessels along the right along medially, not significantly changed. On today's study, there is slight obscuration of the left hemidiaphragm suggesting minimal atelectasis at the left base. There is also hazy opacity in the right cardiophrenic region and blunting of the right and question left costophrenic angles. No frank consolidation is detected. No pneumothorax is identified.
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<unk> year old woman with tachybrady syndrome. // rule out pneumothorax
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Frontal and lateral views of the chest demonstrate normal cardiomediastinal silhouette. The lungs are clear. There is no pneumothorax, vascular congestion, or pleural effusion. A circumscribed area of sclerosis along the anterior superior endplate of t<num> vertebral body is consistent with a bone island, as correlated with prior mri dated <unk>. T<num>-<unk> anterior endplate sclerosis is related to degenerative disease. Trace left costophrenic angle dependent atelectasis is noted.
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<unk>-year-old female with syncope. question pneumonia.
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The lungs are clear. There is no pleural effusion, pneumothorax focal airspace consolidation. Mild cardiomegaly is new since <unk>, but there is no vascular engorgement, edema, or pleural effusion to indicate cardiac decompensation. The hilar and mediastinal contours are unremarkable.
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paresthesias. evaluate for pneumonia.
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The lungs are clear. The heart size is normal. The mediastinal contours are normal. There are no pleural effusions. No pneumothorax is seen.
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chest pain and palpitations. assess for pneumonia.
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Pa and lateral views of the chest are provided. The lungs appear clear. No focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette appears normal. Deformities involving the left fifth, sixth, seventh posterolateral rib arches appear chronic, though were not seen on the prior imaging study. Please correlate for focal pain in this region.
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Pa and lateral views of the chest provided. Lungs are clear. No focal consolidation, effusion, pneumothorax. Cardiomediastinal silhouette appears normal. Bony structures are intact. No free air below the right hemidiaphragm.
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Pa and lateral views of the chest provided demonstrate clear, well-expanded lungs. No focal consolidation, effusion, pneumothorax seen. Cardiomediastinal silhouette is normal. Bony structures are intact. No free air below the right hemidiaphragm.
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Left subclavian line ends at lower svc and the feeding tube ends in the stomach and is appropriately positioned. There are no lung opacities concerning for pneumonia. Heart size, mediastinal and hilar contours are normal. There is no pleural effusion or pneumothorax.
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The lungs are clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities. No free air below the diaphragm.
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<unk>m with intractible paroxysmal hiccups x<num>d // diaphragmatic lower lobe related process? intractible paroxysmal hiccups x<num>d
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Heart size is mildly enlarged. The mediastinal and hilar contours are unremarkable. Atherosclerotic calcifications are noted in the aorta diffusely. Pulmonary vasculature is normal. Blunting of the costophrenic angles posteriorly on the lateral view suggests minimal pleural effusions bilaterally. No focal consolidation or pneumothorax is demonstrated. Mild to moderate multilevel degenerative changes are seen in the thoracic spine.
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history: <unk>f with chest pain
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Et tube in situ with the tip just above the medial clavicles approximately <num> mm proximal to the carina. Right-sided picc line in situ with the tip in the mid to distal svc. No pneumothorax. Ng tube in situ coursing out of sight inferiorly. Bilateral pulmonary venous congestion. Left lower lobe atelectasis with a small associated effusion. Mild right basal atelectasis with a suspected small effusion.
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this is a <unk> yom with a pmh significant for developmental mental delay, seizure disorder, and blindness who is being admitted to the ccu following pericardial drainage for a moderate to large pericardial effusion. currently the patient is hemodynamically stable with drain in place pending extubation and f/u investigation regarding the etiology of his pericardial effusion. // et tube placement
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There is no consolidation, pleural effusion, or pneumothorax. Cardiomediastinal and hilar silhouettes are normal size. Calcification in the anterior upper abdominal soft tissue may be a sequela of prior injury.
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history: <unk>f with recent bariatric surgery, here w// chest pain. atraumatic r shoulder pain // pneumonia
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Frontal radiograph of the chest again demonstrates a swan-ganz catheter which is far past midline into likely segmental right pulmonary artery. It should be retracted by at least <num>-<num> cm for more appropriate positioning in the proximal pulmonary artery. As compared to prior study, the lung volumes remain low, accentuating the cardiac contour. The heart and mediastinum are unremarkable. Diffuse right lung opacities are slightly improved with worsened opacification of the left lung, likely equilibrating pulmonary edema. No pleural abnormality is seen.
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chf, evaluate for interval change in infiltrates.
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