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sae radiography 4

FINAL REPORT INDICATION: Increased leg edema, evaluate for acute cardiac or pulmonary process. COMPARISON: Chest radiograph from ___. FINDINGS: There is a left pacemaker with appropriately positioned right atrial and right ventricular leads. The heart is moderately enlarged, increased in size compared to ___. There is pulmonary venous congestion with cephalization and predominantly perihilar heterogeneous opacities, consistent with mild interstitial pulmonary edema. No pleural effusions or pneumothorax. Possible slight loss of height of a upper mid thoracic vertebral body would be unchanged compared to ___. IMPRESSION: Mild interstitial pulmonary edema thought to be cardiogenic in etiology given increased moderate cardiomegaly.

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Increased leg edema, evaluate for acute cardiac or pulmonary process.

FINAL REPORT INDICATION: Increased leg edema, evaluate for acute cardiac or pulmonary process. COMPARISON: Chest radiograph from ___. FINDINGS: There is a left pacemaker with appropriately positioned right atrial and right ventricular leads. The heart is moderately enlarged, increased in size compared to ___. There is pulmonary venous congestion with cephalization and predominantly perihilar heterogeneous opacities, consistent with mild interstitial pulmonary edema. No pleural effusions or pneumothorax. Possible slight loss of height of a upper mid thoracic vertebral body would be unchanged compared to ___. IMPRESSION: Mild interstitial pulmonary edema thought to be cardiogenic in etiology given increased moderate cardiomegaly.

mimic-cxr-jpg_2.0.0_files_p11_p11928692_s54164323_5475bdcc-37f6b853-142a043b-3e6572f9-5b71d475.jpg

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Increased leg edema, evaluate for acute cardiac or pulmonary process.

FINAL REPORT INDICATION: ___ year old woman with persistent cough and bilateral crackles // rule out pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Prior radiographs the chest dated ___ to ___. FINDINGS: Frontal and lateral radiographs of the chest is limited by underpenetration which is likely secondary to body habitus. The lungs appear clear, however it is not possible to exclude a consolidation in the lateral inferior costophrenic angles. The cardiomediastinal and hilar contours are unchanged. There is no pneumothorax. IMPRESSION: The lungs appear clear, however it is not possible to exclude a consolidation in the lateral inferior costophrenic angles.

mimic-cxr-jpg_2.0.0_files_p11_p11928692_s53222889_d1b9813f-08d920a6-85c9bb6f-c516c1ee-a56f9d38.jpg

[(2, 214, 12, 11), (2, 2, 18, 46)]

[' FINAL REPORT\n INDICATION: Increased leg edema, evaluate for acute cardiac or pulmonary\n process.\n \n COMPARISON: Chest radiograph from ___.\n \n FINDINGS: There is a left pacemaker with appropriately positioned right\n atrial and right ventricular leads. The heart is moderately enlarged,\n increased in size compared to ___. There is pulmonary venous\n congestion with cephalization and predominantly perihilar heterogeneous\n opacities, consistent with mild interstitial pulmonary edema. No pleural\n effusions or pneumothorax. Possible slight loss of height of a upper mid\n thoracic vertebral body would be unchanged compared to ___.\n \n IMPRESSION: Mild interstitial pulmonary edema thought to be cardiogenic in\n etiology given increased moderate cardiomegaly.\n', ' FINAL REPORT\n INDICATION: ___-year-old female with chest pain, evaluate for pneumothorax or\n pneumonia.\n \n COMPARISONS: PA and lateral chest radiograph ___.\n \n PA AND LATERAL CHEST RADIOGRAPH: Left ventricular pacemaker device is again\n noted with appropriately positioned right atrial and right ventricular leads. \n Mild cardiomegaly is unchanged from ___. Mild pulmonary venous\n congestion with cephalization and predominantly perihilar opacities consistent\n with mild interstitial pulmonary edema appears similar to chest radiograph of\n ___. There is no evidence of pleural effusion or pneumothorax. \n There is linear atelectasis at the left lung base, similar to the prior\n examination. Loss of height of a upper mid thoracic vertebral body is\n unchanged compared to ___.\n \n IMPRESSION: Findings suggesting mild interstitial pulmonary edema along with\n mild cardiomegaly and linear atelectasis at the left lung base. No evidence\n of acute pneumonia or pneumothorax.\n']

___ year old woman with persistent cough and bilateral crackles // rule out pneumonia

FINAL REPORT INDICATION: ___ year old woman with persistent cough and bilateral crackles // rule out pneumonia TECHNIQUE: Chest PA and lateral COMPARISON: Prior radiographs the chest dated ___ to ___. FINDINGS: Frontal and lateral radiographs of the chest is limited by underpenetration which is likely secondary to body habitus. The lungs appear clear, however it is not possible to exclude a consolidation in the lateral inferior costophrenic angles. The cardiomediastinal and hilar contours are unchanged. There is no pneumothorax. IMPRESSION: The lungs appear clear, however it is not possible to exclude a consolidation in the lateral inferior costophrenic angles.

mimic-cxr-jpg_2.0.0_files_p11_p11928692_s53222889_6bd4c046-822ab57b-56c2ade0-5990ad2d-449af809.jpg

[(2, 214, 12, 11), (2, 2, 18, 46)]

[' FINAL REPORT\n INDICATION: Increased leg edema, evaluate for acute cardiac or pulmonary\n process.\n \n COMPARISON: Chest radiograph from ___.\n \n FINDINGS: There is a left pacemaker with appropriately positioned right\n atrial and right ventricular leads. The heart is moderately enlarged,\n increased in size compared to ___. There is pulmonary venous\n congestion with cephalization and predominantly perihilar heterogeneous\n opacities, consistent with mild interstitial pulmonary edema. No pleural\n effusions or pneumothorax. Possible slight loss of height of a upper mid\n thoracic vertebral body would be unchanged compared to ___.\n \n IMPRESSION: Mild interstitial pulmonary edema thought to be cardiogenic in\n etiology given increased moderate cardiomegaly.\n', ' FINAL REPORT\n INDICATION: ___-year-old female with chest pain, evaluate for pneumothorax or\n pneumonia.\n \n COMPARISONS: PA and lateral chest radiograph ___.\n \n PA AND LATERAL CHEST RADIOGRAPH: Left ventricular pacemaker device is again\n noted with appropriately positioned right atrial and right ventricular leads. \n Mild cardiomegaly is unchanged from ___. Mild pulmonary venous\n congestion with cephalization and predominantly perihilar opacities consistent\n with mild interstitial pulmonary edema appears similar to chest radiograph of\n ___. There is no evidence of pleural effusion or pneumothorax. \n There is linear atelectasis at the left lung base, similar to the prior\n examination. Loss of height of a upper mid thoracic vertebral body is\n unchanged compared to ___.\n \n IMPRESSION: Findings suggesting mild interstitial pulmonary edema along with\n mild cardiomegaly and linear atelectasis at the left lung base. No evidence\n of acute pneumonia or pneumothorax.\n']

___ year old woman with persistent cough and bilateral crackles // rule out pneumonia

FINAL REPORT INDICATION: ___-year-old female with chest pain, evaluate for pneumothorax or pneumonia. COMPARISONS: PA and lateral chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPH: Left ventricular pacemaker device is again noted with appropriately positioned right atrial and right ventricular leads. Mild cardiomegaly is unchanged from ___. Mild pulmonary venous congestion with cephalization and predominantly perihilar opacities consistent with mild interstitial pulmonary edema appears similar to chest radiograph of ___. There is no evidence of pleural effusion or pneumothorax. There is linear atelectasis at the left lung base, similar to the prior examination. Loss of height of a upper mid thoracic vertebral body is unchanged compared to ___. IMPRESSION: Findings suggesting mild interstitial pulmonary edema along with mild cardiomegaly and linear atelectasis at the left lung base. No evidence of acute pneumonia or pneumothorax.

mimic-cxr-jpg_2.0.0_files_p11_p11928692_s55947318_2c5c8a39-6ae3dd9e-2b4d5279-6bb07505-1b57f5ab.jpg

[(0, 211, 17, 25)]

[' FINAL REPORT\n INDICATION: Increased leg edema, evaluate for acute cardiac or pulmonary\n process.\n \n COMPARISON: Chest radiograph from ___.\n \n FINDINGS: There is a left pacemaker with appropriately positioned right\n atrial and right ventricular leads. The heart is moderately enlarged,\n increased in size compared to ___. There is pulmonary venous\n congestion with cephalization and predominantly perihilar heterogeneous\n opacities, consistent with mild interstitial pulmonary edema. No pleural\n effusions or pneumothorax. Possible slight loss of height of a upper mid\n thoracic vertebral body would be unchanged compared to ___.\n \n IMPRESSION: Mild interstitial pulmonary edema thought to be cardiogenic in\n etiology given increased moderate cardiomegaly.\n']

___-year-old female with chest pain, evaluate for pneumothorax or pneumonia

FINAL REPORT INDICATION: ___-year-old female with near syncope. COMPARISON: ___. TECHNIQUE: Frontal and lateral chest radiographs were obtained. FINDINGS: No focal consolidation, pleural effusion, pneumothorax, or pulmonary edema is detected. Heart and mediastinal contours are stable. Known lung nodules are better assessed by CT. Median sternotomy wires and mediastinal clips are again noted. IMPRESSION: No radiographic evidence for acute cardiopulmonary process.

mimic-cxr-jpg_2.0.0_files_p11_p11879886_s56855230_2aadeb6e-8b5af4b3-f3ddd4f9-8d552d40-d8a5e821.jpg

[(0, 23, 5, 41), (0, 21, 22, 45), (0, 18, 17, 56), (0, 8, 12, 40)]

[' FINAL REPORT\n HISTORY: ___-year-old female with malaise.\n \n COMPARISON: Chest radiograph from ___.\n \n FRONTAL AND LATERAL CHEST RADIOGRAPH: There are diffuse interstitial\n opacities which are new since the prior examination. Though likely due to\n interstitial pulmonary edema given evidence of prior cardiac surgery, there is\n no evidence of central venous engorgement, cardiomegaly or pleural effusions. \n An alternative possibility would be atypical infection in the appropriate\n clinical circumstance. No confluent consolidation is identified. There is no\n pneumothorax. Mediastinal and hilar contours are within normal limits and\n unchanged from prior. Mild cardiomegaly is stable. Post-surgical changes\n from prior CABG are unchanged. Median sternotomy wires appear grossly intact.\n \n IMPRESSION: New diffuse interstitial opacities likely related to pulmonary\n edema, though atypical infection should also be considered.\n', ' FINAL REPORT\n HISTORY: Acute-on-chronic shortness of breath, _____ diastolic CHF, known\n metastatic leiomyosarcoma, CAD status post CABG, question pneumonia, pulmonary\n edema.\n \n CHEST, SINGLE AP PORTABLE VIEW.\n \n Rotated positioning. The patient is status post sternotomy, with\n cardiomegaly. There is upper zone redistribution and diffuse vascular\n blurring, consistent with CHF. The left hemidiaphragm is elevated, likely\n accentuated by what appears to be air within the fundus, dilating the gastric\n fundus. Aside from some increased retrocardiac density, no frank\n consolidation or gross effusion is identified.\n \n IMPRESSION: CHF with upper zone redistribution and diffuse vascular blurring.\n Minimal left lower lobe opacity also noted. Of note, the chest CT from\n ___ described innumerable pulmonary nodules. It would be difficult to\n distinguish interstitial metastatic disease from the findings on the current\n study, but the upper zone redistribution and overall blurring does appear more\n pronounced than on ___ and that rapid change supports the diagnosis of CHF.\n', ' FINAL REPORT\n INDICATION: ___-year-old woman with congestive cardiac failure, pneumonia, now\n continued to spike fevers despite antibiotics.\n \n COMPARISON: PA and lateral chest radiograph ___.\n \n PA AND LATERAL CHEST RADIOGRAPH: Sternotomy wires are midline and intact. \n Bilateral interstitial edema has decreased since the most recent prior\n examination. Cardiomegaly is stable. Surgical clips in the mediastinum,\n unchanged. Opacification at the left lung base is resolved. Minimal\n opacification right lung base concerning likely related to infection or edema\n is improved compared to the prior examination.\n', ' FINAL REPORT\n CHEST RADIOGRAPH PERFORMED ON ___\n \n COMPARISON: ___.\n \n CLINICAL HISTORY: Fatigue. Assess for pneumonia.\n \n FINDINGS: PA and lateral views of the chest were obtained. Midline\n sternotomy wires and mediastinal clips are again noted. The lungs appear\n clear bilaterally without definite signs of pneumonia or CHF. The patient is\n known to have multiple pulmonary metastases which are not well seen. A lesion\n in the left lower lobe projects over the posterior margin of the heart on the\n lateral view. A nodular opacity is again noted in the left upper lobe. No\n pleural effusion or pneumothorax. Heart size is stable. Mediastinal contour\n is also stable. Bony structures appear intact.\n \n IMPRESSION: Known lung metastases are again noted though better assessed on\n prior CT. No definite signs of superimposed acute process.\n']

___-year-old female with near syncope

FINAL REPORT INDICATION: ___-year-old female with shortness of breath and history of aortic stenosis. Evaluate for evidence of cardiopulmonary process. COMPARISON: ___. TECHNIQUE: PA and lateral chest radiograph. FINDINGS: A left hilar mass is noted, which appears new compared with prior exam of ___. There is also increased vascular markings in the remaining lung fields as well as a new left-sided pleural effusion. There is mild-to-moderate cardiomegaly which appears to be slightly worsened compared with prior exam. There is no pneumothorax. Sternotomy wires are intact. Multiple surgical clips are noted in the left hemithorax. IMPRESSION: 1. New left hilar mass. A CT is recommended for further assessment. 2. Cardiomegaly associated to increased vascular markings and pleural effusion suggests pulmonary vascular congestion.

mimic-cxr-jpg_2.0.0_files_p11_p11879886_s53021526_27a4f085-5eaad330-a1153870-3ec2cd19-20a604cd.jpg

[(0, 104, 19, 19), (0, 103, 12, 23), (0, 100, 7, 34), (0, 90, 2, 18), (0, 81, 13, 38)]

[' FINAL REPORT\n HISTORY: ___-year-old female with malaise.\n \n COMPARISON: Chest radiograph from ___.\n \n FRONTAL AND LATERAL CHEST RADIOGRAPH: There are diffuse interstitial\n opacities which are new since the prior examination. Though likely due to\n interstitial pulmonary edema given evidence of prior cardiac surgery, there is\n no evidence of central venous engorgement, cardiomegaly or pleural effusions. \n An alternative possibility would be atypical infection in the appropriate\n clinical circumstance. No confluent consolidation is identified. There is no\n pneumothorax. Mediastinal and hilar contours are within normal limits and\n unchanged from prior. Mild cardiomegaly is stable. Post-surgical changes\n from prior CABG are unchanged. Median sternotomy wires appear grossly intact.\n \n IMPRESSION: New diffuse interstitial opacities likely related to pulmonary\n edema, though atypical infection should also be considered.\n', ' FINAL REPORT\n HISTORY: Acute-on-chronic shortness of breath, _____ diastolic CHF, known\n metastatic leiomyosarcoma, CAD status post CABG, question pneumonia, pulmonary\n edema.\n \n CHEST, SINGLE AP PORTABLE VIEW.\n \n Rotated positioning. The patient is status post sternotomy, with\n cardiomegaly. There is upper zone redistribution and diffuse vascular\n blurring, consistent with CHF. The left hemidiaphragm is elevated, likely\n accentuated by what appears to be air within the fundus, dilating the gastric\n fundus. Aside from some increased retrocardiac density, no frank\n consolidation or gross effusion is identified.\n \n IMPRESSION: CHF with upper zone redistribution and diffuse vascular blurring.\n Minimal left lower lobe opacity also noted. Of note, the chest CT from\n ___ described innumerable pulmonary nodules. It would be difficult to\n distinguish interstitial metastatic disease from the findings on the current\n study, but the upper zone redistribution and overall blurring does appear more\n pronounced than on ___ and that rapid change supports the diagnosis of CHF.\n', ' FINAL REPORT\n INDICATION: ___-year-old woman with congestive cardiac failure, pneumonia, now\n continued to spike fevers despite antibiotics.\n \n COMPARISON: PA and lateral chest radiograph ___.\n \n PA AND LATERAL CHEST RADIOGRAPH: Sternotomy wires are midline and intact. \n Bilateral interstitial edema has decreased since the most recent prior\n examination. Cardiomegaly is stable. Surgical clips in the mediastinum,\n unchanged. Opacification at the left lung base is resolved. Minimal\n opacification right lung base concerning likely related to infection or edema\n is improved compared to the prior examination.\n', ' FINAL REPORT\n CHEST RADIOGRAPH PERFORMED ON ___\n \n COMPARISON: ___.\n \n CLINICAL HISTORY: Fatigue. Assess for pneumonia.\n \n FINDINGS: PA and lateral views of the chest were obtained. Midline\n sternotomy wires and mediastinal clips are again noted. The lungs appear\n clear bilaterally without definite signs of pneumonia or CHF. The patient is\n known to have multiple pulmonary metastases which are not well seen. A lesion\n in the left lower lobe projects over the posterior margin of the heart on the\n lateral view. A nodular opacity is again noted in the left upper lobe. No\n pleural effusion or pneumothorax. Heart size is stable. Mediastinal contour\n is also stable. Bony structures appear intact.\n \n IMPRESSION: Known lung metastases are again noted though better assessed on\n prior CT. No definite signs of superimposed acute process.\n', ' FINAL REPORT\n INDICATION: ___-year-old female with near syncope.\n \n COMPARISON: ___.\n \n TECHNIQUE: Frontal and lateral chest radiographs were obtained.\n \n FINDINGS: No focal consolidation, pleural effusion, pneumothorax, or\n pulmonary edema is detected. Heart and mediastinal contours are stable. \n Known lung nodules are better assessed by CT. Median sternotomy wires and\n mediastinal clips are again noted.\n \n IMPRESSION: No radiographic evidence for acute cardiopulmonary process.\n']

___-year-old female with shortness of breath and history of aortic stenosis. Evaluate for evidence of cardiopulmonary process.

FINAL REPORT HISTORY: ___-year-old female with malaise. COMPARISON: Chest radiograph from ___. FRONTAL AND LATERAL CHEST RADIOGRAPH: There are diffuse interstitial opacities which are new since the prior examination. Though likely due to interstitial pulmonary edema given evidence of prior cardiac surgery, there is no evidence of central venous engorgement, cardiomegaly or pleural effusions. An alternative possibility would be atypical infection in the appropriate clinical circumstance. No confluent consolidation is identified. There is no pneumothorax. Mediastinal and hilar contours are within normal limits and unchanged from prior. Mild cardiomegaly is stable. Post-surgical changes from prior CABG are unchanged. Median sternotomy wires appear grossly intact. IMPRESSION: New diffuse interstitial opacities likely related to pulmonary edema, though atypical infection should also be considered.

mimic-cxr-jpg_2.0.0_files_p11_p11879886_s54357764_94795c9f-9f6f801d-ed57d02c-5e9e02be-b35bf9a1.jpg

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malaise

FINAL REPORT INDICATION: ___-year-old woman with congestive cardiac failure, pneumonia, now continued to spike fevers despite antibiotics. COMPARISON: PA and lateral chest radiograph ___. PA AND LATERAL CHEST RADIOGRAPH: Sternotomy wires are midline and intact. Bilateral interstitial edema has decreased since the most recent prior examination. Cardiomegaly is stable. Surgical clips in the mediastinum, unchanged. Opacification at the left lung base is resolved. Minimal opacification right lung base concerning likely related to infection or edema is improved compared to the prior examination.

mimic-cxr-jpg_2.0.0_files_p11_p11879886_s51551069_58fedcf0-3247be4c-33428852-1d9d9fed-c613aa80.jpg

[(0, 4, 11, 45), (0, 3, 4, 49)]

[' FINAL REPORT\n HISTORY: ___-year-old female with malaise.\n \n COMPARISON: Chest radiograph from ___.\n \n FRONTAL AND LATERAL CHEST RADIOGRAPH: There are diffuse interstitial\n opacities which are new since the prior examination. Though likely due to\n interstitial pulmonary edema given evidence of prior cardiac surgery, there is\n no evidence of central venous engorgement, cardiomegaly or pleural effusions. \n An alternative possibility would be atypical infection in the appropriate\n clinical circumstance. No confluent consolidation is identified. There is no\n pneumothorax. Mediastinal and hilar contours are within normal limits and\n unchanged from prior. Mild cardiomegaly is stable. Post-surgical changes\n from prior CABG are unchanged. Median sternotomy wires appear grossly intact.\n \n IMPRESSION: New diffuse interstitial opacities likely related to pulmonary\n edema, though atypical infection should also be considered.\n', ' FINAL REPORT\n HISTORY: Acute-on-chronic shortness of breath, _____ diastolic CHF, known\n metastatic leiomyosarcoma, CAD status post CABG, question pneumonia, pulmonary\n edema.\n \n CHEST, SINGLE AP PORTABLE VIEW.\n \n Rotated positioning. The patient is status post sternotomy, with\n cardiomegaly. There is upper zone redistribution and diffuse vascular\n blurring, consistent with CHF. The left hemidiaphragm is elevated, likely\n accentuated by what appears to be air within the fundus, dilating the gastric\n fundus. Aside from some increased retrocardiac density, no frank\n consolidation or gross effusion is identified.\n \n IMPRESSION: CHF with upper zone redistribution and diffuse vascular blurring.\n Minimal left lower lobe opacity also noted. Of note, the chest CT from\n ___ described innumerable pulmonary nodules. It would be difficult to\n distinguish interstitial metastatic disease from the findings on the current\n study, but the upper zone redistribution and overall blurring does appear more\n pronounced than on ___ and that rapid change supports the diagnosis of CHF.\n']

___-year-old woman with congestive cardiac failure, pneumonia, now continued to spike fevers despite antibiotics

FINAL REPORT HISTORY: Acute-on-chronic shortness of breath, _____ diastolic CHF, known metastatic leiomyosarcoma, CAD status post CABG, question pneumonia, pulmonary edema. CHEST, SINGLE AP PORTABLE VIEW. Rotated positioning. The patient is status post sternotomy, with cardiomegaly. There is upper zone redistribution and diffuse vascular blurring, consistent with CHF. The left hemidiaphragm is elevated, likely accentuated by what appears to be air within the fundus, dilating the gastric fundus. Aside from some increased retrocardiac density, no frank consolidation or gross effusion is identified. IMPRESSION: CHF with upper zone redistribution and diffuse vascular blurring. Minimal left lower lobe opacity also noted. Of note, the chest CT from ___ described innumerable pulmonary nodules. It would be difficult to distinguish interstitial metastatic disease from the findings on the current study, but the upper zone redistribution and overall blurring does appear more pronounced than on ___ and that rapid change supports the diagnosis of CHF.

mimic-cxr-jpg_2.0.0_files_p11_p11879886_s56268607_da8cd0dd-573be530-0024ff8e-15e20b59-21e4a61d.jpg

[(0, 1, 6, 56)]

[' FINAL REPORT\n HISTORY: ___-year-old female with malaise.\n \n COMPARISON: Chest radiograph from ___.\n \n FRONTAL AND LATERAL CHEST RADIOGRAPH: There are diffuse interstitial\n opacities which are new since the prior examination. Though likely due to\n interstitial pulmonary edema given evidence of prior cardiac surgery, there is\n no evidence of central venous engorgement, cardiomegaly or pleural effusions. \n An alternative possibility would be atypical infection in the appropriate\n clinical circumstance. No confluent consolidation is identified. There is no\n pneumothorax. Mediastinal and hilar contours are within normal limits and\n unchanged from prior. Mild cardiomegaly is stable. Post-surgical changes\n from prior CABG are unchanged. Median sternotomy wires appear grossly intact.\n \n IMPRESSION: New diffuse interstitial opacities likely related to pulmonary\n edema, though atypical infection should also be considered.\n']

Acute-on-chronic shortness of breath, diastolic CHF, known metastatic leiomyosarcoma, CAD status post CABG, question pneumonia, pulmonary edema.

FINAL REPORT CHEST RADIOGRAPH PERFORMED ON ___ COMPARISON: ___. CLINICAL HISTORY: Fatigue. Assess for pneumonia. FINDINGS: PA and lateral views of the chest were obtained. Midline sternotomy wires and mediastinal clips are again noted. The lungs appear clear bilaterally without definite signs of pneumonia or CHF. The patient is known to have multiple pulmonary metastases which are not well seen. A lesion in the left lower lobe projects over the posterior margin of the heart on the lateral view. A nodular opacity is again noted in the left upper lobe. No pleural effusion or pneumothorax. Heart size is stable. Mediastinal contour is also stable. Bony structures appear intact. IMPRESSION: Known lung metastases are again noted though better assessed on prior CT. No definite signs of superimposed acute process.

mimic-cxr-jpg_2.0.0_files_p11_p11879886_s54972841_12fcd1f0-96b6eb00-a6a5ee27-7e8d19ee-63f16bc2.jpg

[(0, 14, 17, 1), (0, 13, 10, 5), (0, 10, 5, 16)]

[' FINAL REPORT\n HISTORY: ___-year-old female with malaise.\n \n COMPARISON: Chest radiograph from ___.\n \n FRONTAL AND LATERAL CHEST RADIOGRAPH: There are diffuse interstitial\n opacities which are new since the prior examination. Though likely due to\n interstitial pulmonary edema given evidence of prior cardiac surgery, there is\n no evidence of central venous engorgement, cardiomegaly or pleural effusions. \n An alternative possibility would be atypical infection in the appropriate\n clinical circumstance. No confluent consolidation is identified. There is no\n pneumothorax. Mediastinal and hilar contours are within normal limits and\n unchanged from prior. Mild cardiomegaly is stable. Post-surgical changes\n from prior CABG are unchanged. Median sternotomy wires appear grossly intact.\n \n IMPRESSION: New diffuse interstitial opacities likely related to pulmonary\n edema, though atypical infection should also be considered.\n', ' FINAL REPORT\n HISTORY: Acute-on-chronic shortness of breath, _____ diastolic CHF, known\n metastatic leiomyosarcoma, CAD status post CABG, question pneumonia, pulmonary\n edema.\n \n CHEST, SINGLE AP PORTABLE VIEW.\n \n Rotated positioning. The patient is status post sternotomy, with\n cardiomegaly. There is upper zone redistribution and diffuse vascular\n blurring, consistent with CHF. The left hemidiaphragm is elevated, likely\n accentuated by what appears to be air within the fundus, dilating the gastric\n fundus. Aside from some increased retrocardiac density, no frank\n consolidation or gross effusion is identified.\n \n IMPRESSION: CHF with upper zone redistribution and diffuse vascular blurring.\n Minimal left lower lobe opacity also noted. Of note, the chest CT from\n ___ described innumerable pulmonary nodules. It would be difficult to\n distinguish interstitial metastatic disease from the findings on the current\n study, but the upper zone redistribution and overall blurring does appear more\n pronounced than on ___ and that rapid change supports the diagnosis of CHF.\n', ' FINAL REPORT\n INDICATION: ___-year-old woman with congestive cardiac failure, pneumonia, now\n continued to spike fevers despite antibiotics.\n \n COMPARISON: PA and lateral chest radiograph ___.\n \n PA AND LATERAL CHEST RADIOGRAPH: Sternotomy wires are midline and intact. \n Bilateral interstitial edema has decreased since the most recent prior\n examination. Cardiomegaly is stable. Surgical clips in the mediastinum,\n unchanged. Opacification at the left lung base is resolved. Minimal\n opacification right lung base concerning likely related to infection or edema\n is improved compared to the prior examination.\n']

Fatigue. Assess for pneumonia.

FINAL REPORT CHEST RADIOGRAPH INDICATION: Extubation, evaluation for pleural effusion. COMPARISON: ___. FINDINGS: As compared to the previous exam, the patient has been extubated and the nasogastric tube has been removed. The extent of the pre-existing pleural effusions have bilaterally increased. There is moderate-to-extensive cardiomegaly with bilateral extensive areas of atelectasis. Mild-to-moderate fluid overload. No focal parenchymal opacity suggest pneumonia.

mimic-cxr-jpg_2.0.0_files_p11_p11022245_s56603583_777626de-a55fbd7d-e30f8359-db74c619-80afa62d.jpg

[(0, 8, 8, 16), (0, 7, 3, 47), (0, 5, 22, 21), (0, 5, 4, 22), (0, 2, 22, 48), (0, 0, 18, 9)]

[' FINAL REPORT\n CLINICAL INFORMATION: ___-year-old male with CHF versus pneumonia, intubated.\n \n COMPARISON: None.\n \n FINDINGS: Portable frontal chest radiographs demonstrate intubated patient,\n the tip of the endotracheal tube is positioned 4.1 cm from the level of the\n carina. An orogastric tube is in place and is coiled within the fundus of the\n stomach. There is airspace opacification of the right lung with relative\n sparing of the apex, as well as basilar left lung opacity. Linear atelectasis\n is seen in the right mid lung. The left lung is relatively clear. A focal\n nodular opacity is seen in the left upper lung measuring 8 mm. There is\n linear atelectasis in the left lower lung. There is no definite effusion. \n There is no pneumothorax. \n \n The heart size is enlarged, the mediastinal contours appear grossly\n unremarkable on this portable film.\n \n IMPRESSION:\n 1. Bilateral airspace opacity consistent with lobar pneumonia.\n \n 2. Nodular opacity in the left lung apex, recommend attention on followup.\n \n 3. Moderate cardiomegaly.\n', ' FINAL REPORT\n SINGLE FRONTAL VIEW OF THE CHEST\n \n REASON FOR EXAM: Pneumonia, bacteremia, intubated patient.\n \n Comparison is made to prior study performed a day earlier.\n \n Lines and tubes are in unchanged standard position. Multifocal\n consolidations in the right upper and lower lobes bilaterally left greater\n than right are unchanged. Severe cardiomegaly is stable. There are no new\n lung abnormalities. Probably small right pleural effusion is unchanged.\n', ' FINAL REPORT\n REASON FOR EXAMINATION: Evaluation of the patient with endocarditis,\n intubated.\n \n AP radiograph of the chest was reviewed in comparison to ___.\n \n The ET tube tip is 5 cm above the carina. The right internal jugular line tip\n is at the level of mid SVC. Cardiomegaly is unchanged, moderate to severe. \n The patient continues to be in mild pulmonary edema. Right upper lobe opacity\n appears to be unchanged, representing right upper lobe consolidation, better\n appreciated on the chest CT obtained on ___. Left basal consolidation\n is better appreciated on CT and obscured by the cardiomegaly and pleural\n effusion on the current radiograph.\n', ' PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:38 AM\n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n ______________________________________________________________________________\n FINAL REPORT\n HISTORY: ___-year-old male with endocarditis and intubated.\n \n STUDY: Portable AP semi-upright chest radiograph.\n \n COMPARISON: ___.\n \n FINDINGS: The endotracheal tube tip sits 5 cm above the carina. A left-sided\n IJ central venous catheter tip sits in the left brachiocephalic vein. The\n right-sided IJ central venous catheter tip sits in the upper SVC. The heart\n size is large but stable. The mediastinal contours are within normal limits. \n There continue to be bibasilar and perihilar opacities as well as a more\n rounded confluent opacity in the right upper lung. These findings likely\n represent increased pulmonary edema as well as right upper and lower lobe\n consolidations. Retrocardiac opacity is also compatible with a left lower\n lobe consolidation. The costophrenic angles are excluded from the study\n limiting assessment for subtle pleural effusion. There is no large\n pneumothorax.\n \n IMPRESSION: \n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n', ' WET READ: ___ ___ ___ 2:09 PM\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n ______________________________________________________________________________\n FINAL REPORT\n INDICATION: Status post AVR, question pneumothorax after chest tube removal.\n \n COMPARISON: Chest radiograph on ___.\n \n FINDINGS: One portable AP view of the chest. The Swan-Ganz catheter through\n a right internal jugular approach ends in the region of the main pulmonary\n artery. The left internal jugular catheter ends in the left brachiocephalic\n vein just before the SVC. Endotracheal tube ends 6 cm from the carina. The\n previously seen moderate-to-severe pulmonary edema has slightly improved. The\n right upper lobe parenchymal opacity is unchanged. Mild cardiomegaly is\n stable. Mediastinal and hilar contours are normal. No pneumothorax.\n \n IMPRESSION:\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n', ' FINAL REPORT\n CHEST RADIOGRAPH \n \n INDICATION: Evaluation for pleural effusions.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous radiograph, the right-sided pleural\n effusion has minimally decreased. On the left, however, the effusion has\n substantially increased and leads to a near total opacification of the left\n hemithorax. Subsequently, severe atelectatic changes are present.\n \n The Swan-Ganz catheter has been removed, the right internal jugular vein\n catheter has also been removed, a nasogastric tube, the endotracheal tube and\n a venous introduction sheath remains in situ.\n']

Extubation, evaluation for pleural effusion

FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for pleural effusions. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the right-sided pleural effusion has minimally decreased. On the left, however, the effusion has substantially increased and leads to a near total opacification of the left hemithorax. Subsequently, severe atelectatic changes are present. The Swan-Ganz catheter has been removed, the right internal jugular vein catheter has also been removed, a nasogastric tube, the endotracheal tube and a venous introduction sheath remains in situ.

mimic-cxr-jpg_2.0.0_files_p11_p11022245_s57185571_a3539c79-41479e80-4150d89e-96e86692-6876133e.jpg

[(0, 7, 14, 7), (0, 6, 9, 38), (0, 5, 4, 12), (0, 4, 10, 13), (0, 2, 4, 39)]

[' FINAL REPORT\n CLINICAL INFORMATION: ___-year-old male with CHF versus pneumonia, intubated.\n \n COMPARISON: None.\n \n FINDINGS: Portable frontal chest radiographs demonstrate intubated patient,\n the tip of the endotracheal tube is positioned 4.1 cm from the level of the\n carina. An orogastric tube is in place and is coiled within the fundus of the\n stomach. There is airspace opacification of the right lung with relative\n sparing of the apex, as well as basilar left lung opacity. Linear atelectasis\n is seen in the right mid lung. The left lung is relatively clear. A focal\n nodular opacity is seen in the left upper lung measuring 8 mm. There is\n linear atelectasis in the left lower lung. There is no definite effusion. \n There is no pneumothorax. \n \n The heart size is enlarged, the mediastinal contours appear grossly\n unremarkable on this portable film.\n \n IMPRESSION:\n 1. Bilateral airspace opacity consistent with lobar pneumonia.\n \n 2. Nodular opacity in the left lung apex, recommend attention on followup.\n \n 3. Moderate cardiomegaly.\n', ' FINAL REPORT\n SINGLE FRONTAL VIEW OF THE CHEST\n \n REASON FOR EXAM: Pneumonia, bacteremia, intubated patient.\n \n Comparison is made to prior study performed a day earlier.\n \n Lines and tubes are in unchanged standard position. Multifocal\n consolidations in the right upper and lower lobes bilaterally left greater\n than right are unchanged. Severe cardiomegaly is stable. There are no new\n lung abnormalities. Probably small right pleural effusion is unchanged.\n', ' FINAL REPORT\n REASON FOR EXAMINATION: Evaluation of the patient with endocarditis,\n intubated.\n \n AP radiograph of the chest was reviewed in comparison to ___.\n \n The ET tube tip is 5 cm above the carina. The right internal jugular line tip\n is at the level of mid SVC. Cardiomegaly is unchanged, moderate to severe. \n The patient continues to be in mild pulmonary edema. Right upper lobe opacity\n appears to be unchanged, representing right upper lobe consolidation, better\n appreciated on the chest CT obtained on ___. Left basal consolidation\n is better appreciated on CT and obscured by the cardiomegaly and pleural\n effusion on the current radiograph.\n', ' PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:38 AM\n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n ______________________________________________________________________________\n FINAL REPORT\n HISTORY: ___-year-old male with endocarditis and intubated.\n \n STUDY: Portable AP semi-upright chest radiograph.\n \n COMPARISON: ___.\n \n FINDINGS: The endotracheal tube tip sits 5 cm above the carina. A left-sided\n IJ central venous catheter tip sits in the left brachiocephalic vein. The\n right-sided IJ central venous catheter tip sits in the upper SVC. The heart\n size is large but stable. The mediastinal contours are within normal limits. \n There continue to be bibasilar and perihilar opacities as well as a more\n rounded confluent opacity in the right upper lung. These findings likely\n represent increased pulmonary edema as well as right upper and lower lobe\n consolidations. Retrocardiac opacity is also compatible with a left lower\n lobe consolidation. The costophrenic angles are excluded from the study\n limiting assessment for subtle pleural effusion. There is no large\n pneumothorax.\n \n IMPRESSION: \n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n', ' WET READ: ___ ___ ___ 2:09 PM\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n ______________________________________________________________________________\n FINAL REPORT\n INDICATION: Status post AVR, question pneumothorax after chest tube removal.\n \n COMPARISON: Chest radiograph on ___.\n \n FINDINGS: One portable AP view of the chest. The Swan-Ganz catheter through\n a right internal jugular approach ends in the region of the main pulmonary\n artery. The left internal jugular catheter ends in the left brachiocephalic\n vein just before the SVC. Endotracheal tube ends 6 cm from the carina. The\n previously seen moderate-to-severe pulmonary edema has slightly improved. The\n right upper lobe parenchymal opacity is unchanged. Mild cardiomegaly is\n stable. Mediastinal and hilar contours are normal. No pneumothorax.\n \n IMPRESSION:\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n']

Evaluation for pleural effusions

FINAL REPORT CHEST RADIOGRAPH INDICATION: Evaluation for pleural effusions. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the right-sided pleural effusion has minimally decreased. On the left, however, the effusion has substantially increased and leads to a near total opacification of the left hemithorax. Subsequently, severe atelectatic changes are present. The Swan-Ganz catheter has been removed, the right internal jugular vein catheter has also been removed, a nasogastric tube, the endotracheal tube and a venous introduction sheath remains in situ.

mimic-cxr-jpg_2.0.0_files_p11_p11022245_s57185571_c2ace888-d3f68f82-2d5b5dd6-07dc85c9-327c4bce.jpg

[(0, 7, 14, 7), (0, 6, 9, 38), (0, 5, 4, 12), (0, 4, 10, 13), (0, 2, 4, 39)]

[' FINAL REPORT\n CLINICAL INFORMATION: ___-year-old male with CHF versus pneumonia, intubated.\n \n COMPARISON: None.\n \n FINDINGS: Portable frontal chest radiographs demonstrate intubated patient,\n the tip of the endotracheal tube is positioned 4.1 cm from the level of the\n carina. An orogastric tube is in place and is coiled within the fundus of the\n stomach. There is airspace opacification of the right lung with relative\n sparing of the apex, as well as basilar left lung opacity. Linear atelectasis\n is seen in the right mid lung. The left lung is relatively clear. A focal\n nodular opacity is seen in the left upper lung measuring 8 mm. There is\n linear atelectasis in the left lower lung. There is no definite effusion. \n There is no pneumothorax. \n \n The heart size is enlarged, the mediastinal contours appear grossly\n unremarkable on this portable film.\n \n IMPRESSION:\n 1. Bilateral airspace opacity consistent with lobar pneumonia.\n \n 2. Nodular opacity in the left lung apex, recommend attention on followup.\n \n 3. Moderate cardiomegaly.\n', ' FINAL REPORT\n SINGLE FRONTAL VIEW OF THE CHEST\n \n REASON FOR EXAM: Pneumonia, bacteremia, intubated patient.\n \n Comparison is made to prior study performed a day earlier.\n \n Lines and tubes are in unchanged standard position. Multifocal\n consolidations in the right upper and lower lobes bilaterally left greater\n than right are unchanged. Severe cardiomegaly is stable. There are no new\n lung abnormalities. Probably small right pleural effusion is unchanged.\n', ' FINAL REPORT\n REASON FOR EXAMINATION: Evaluation of the patient with endocarditis,\n intubated.\n \n AP radiograph of the chest was reviewed in comparison to ___.\n \n The ET tube tip is 5 cm above the carina. The right internal jugular line tip\n is at the level of mid SVC. Cardiomegaly is unchanged, moderate to severe. \n The patient continues to be in mild pulmonary edema. Right upper lobe opacity\n appears to be unchanged, representing right upper lobe consolidation, better\n appreciated on the chest CT obtained on ___. Left basal consolidation\n is better appreciated on CT and obscured by the cardiomegaly and pleural\n effusion on the current radiograph.\n', ' PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:38 AM\n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n ______________________________________________________________________________\n FINAL REPORT\n HISTORY: ___-year-old male with endocarditis and intubated.\n \n STUDY: Portable AP semi-upright chest radiograph.\n \n COMPARISON: ___.\n \n FINDINGS: The endotracheal tube tip sits 5 cm above the carina. A left-sided\n IJ central venous catheter tip sits in the left brachiocephalic vein. The\n right-sided IJ central venous catheter tip sits in the upper SVC. The heart\n size is large but stable. The mediastinal contours are within normal limits. \n There continue to be bibasilar and perihilar opacities as well as a more\n rounded confluent opacity in the right upper lung. These findings likely\n represent increased pulmonary edema as well as right upper and lower lobe\n consolidations. Retrocardiac opacity is also compatible with a left lower\n lobe consolidation. The costophrenic angles are excluded from the study\n limiting assessment for subtle pleural effusion. There is no large\n pneumothorax.\n \n IMPRESSION: \n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n', ' WET READ: ___ ___ ___ 2:09 PM\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n ______________________________________________________________________________\n FINAL REPORT\n INDICATION: Status post AVR, question pneumothorax after chest tube removal.\n \n COMPARISON: Chest radiograph on ___.\n \n FINDINGS: One portable AP view of the chest. The Swan-Ganz catheter through\n a right internal jugular approach ends in the region of the main pulmonary\n artery. The left internal jugular catheter ends in the left brachiocephalic\n vein just before the SVC. Endotracheal tube ends 6 cm from the carina. The\n previously seen moderate-to-severe pulmonary edema has slightly improved. The\n right upper lobe parenchymal opacity is unchanged. Mild cardiomegaly is\n stable. Mediastinal and hilar contours are normal. No pneumothorax.\n \n IMPRESSION:\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n']

Evaluation for pleural effusions

PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:38 AM 1. Lines and tubes in place. 2. Increased pulmonary edema with right upper lobe and bibasilar consolidations. ______________________________________________________________________________ FINAL REPORT HISTORY: ___-year-old male with endocarditis and intubated. STUDY: Portable AP semi-upright chest radiograph. COMPARISON: ___. FINDINGS: The endotracheal tube tip sits 5 cm above the carina. A left-sided IJ central venous catheter tip sits in the left brachiocephalic vein. The right-sided IJ central venous catheter tip sits in the upper SVC. The heart size is large but stable. The mediastinal contours are within normal limits. There continue to be bibasilar and perihilar opacities as well as a more rounded confluent opacity in the right upper lung. These findings likely represent increased pulmonary edema as well as right upper and lower lobe consolidations. Retrocardiac opacity is also compatible with a left lower lobe consolidation. The costophrenic angles are excluded from the study limiting assessment for subtle pleural effusion. There is no large pneumothorax. IMPRESSION: 1. Lines and tubes in place. 2. Increased pulmonary edema with right upper lobe and bibasilar consolidations.

mimic-cxr-jpg_2.0.0_files_p11_p11022245_s50146341_b418d709-571d80f6-35f680e3-16a938ff-bde93b89.jpg

[(0, 3, 3, 54), (0, 1, 23, 25), (0, 0, 17, 59)]

[' FINAL REPORT\n CLINICAL INFORMATION: ___-year-old male with CHF versus pneumonia, intubated.\n \n COMPARISON: None.\n \n FINDINGS: Portable frontal chest radiographs demonstrate intubated patient,\n the tip of the endotracheal tube is positioned 4.1 cm from the level of the\n carina. An orogastric tube is in place and is coiled within the fundus of the\n stomach. There is airspace opacification of the right lung with relative\n sparing of the apex, as well as basilar left lung opacity. Linear atelectasis\n is seen in the right mid lung. The left lung is relatively clear. A focal\n nodular opacity is seen in the left upper lung measuring 8 mm. There is\n linear atelectasis in the left lower lung. There is no definite effusion. \n There is no pneumothorax. \n \n The heart size is enlarged, the mediastinal contours appear grossly\n unremarkable on this portable film.\n \n IMPRESSION:\n 1. Bilateral airspace opacity consistent with lobar pneumonia.\n \n 2. Nodular opacity in the left lung apex, recommend attention on followup.\n \n 3. Moderate cardiomegaly.\n', ' FINAL REPORT\n SINGLE FRONTAL VIEW OF THE CHEST\n \n REASON FOR EXAM: Pneumonia, bacteremia, intubated patient.\n \n Comparison is made to prior study performed a day earlier.\n \n Lines and tubes are in unchanged standard position. Multifocal\n consolidations in the right upper and lower lobes bilaterally left greater\n than right are unchanged. Severe cardiomegaly is stable. There are no new\n lung abnormalities. Probably small right pleural effusion is unchanged.\n', ' FINAL REPORT\n REASON FOR EXAMINATION: Evaluation of the patient with endocarditis,\n intubated.\n \n AP radiograph of the chest was reviewed in comparison to ___.\n \n The ET tube tip is 5 cm above the carina. The right internal jugular line tip\n is at the level of mid SVC. Cardiomegaly is unchanged, moderate to severe. \n The patient continues to be in mild pulmonary edema. Right upper lobe opacity\n appears to be unchanged, representing right upper lobe consolidation, better\n appreciated on the chest CT obtained on ___. Left basal consolidation\n is better appreciated on CT and obscured by the cardiomegaly and pleural\n effusion on the current radiograph.\n']

endocarditis and intubated

FINAL REPORT INDICATION: Status post AVR, assess for effusion. TECHNIQUE: PA and Lateral radiographs COMPARISONS: Multiple priors most recently ___ FINDINGS: Rounded right midlung opacity compatible with previously described septic embolus is decreased in size from the prior study. Left midlung rounded consolidation is more conspicuous than previously seen. Potential etiologies include developing pneumonia, additional septic embolus or collection of fissural fluid, though the lateral argues against the latter. Small left pleural effusion is noted along with left greater than right bibasilar atelectasis. Marked enlargement of the cardiac silhouette is similar to the study from ___ though notably larger than the immediate post-procedure study from ___. Left PICC is in satisfactory position in the superior cavoatrial junction. Median sternotomy wires and aortic valve replacement are also noted. IMPRESSION: 1. More conspicuous left midlung opacity concerning for developing pneumonia or septic embolus. 2. Improved small left pleural effusion and left greater than right bibasilar atelectasis. Findings were discussed by telephone with ___, NP, by Dr. ___ on ___ at ___.

mimic-cxr-jpg_2.0.0_files_p11_p11022245_s53978610_957e4fa0-2b741119-9fb1f79c-62130589-86d6cbed.jpg

[(0, 10, 9, 35), (0, 9, 5, 6), (0, 7, 23, 40), (0, 7, 5, 41), (0, 5, 0, 7), (0, 2, 19, 28), (0, 2, 1, 19), (0, 1, 21, 29)]

[' FINAL REPORT\n CLINICAL INFORMATION: ___-year-old male with CHF versus pneumonia, intubated.\n \n COMPARISON: None.\n \n FINDINGS: Portable frontal chest radiographs demonstrate intubated patient,\n the tip of the endotracheal tube is positioned 4.1 cm from the level of the\n carina. An orogastric tube is in place and is coiled within the fundus of the\n stomach. There is airspace opacification of the right lung with relative\n sparing of the apex, as well as basilar left lung opacity. Linear atelectasis\n is seen in the right mid lung. The left lung is relatively clear. A focal\n nodular opacity is seen in the left upper lung measuring 8 mm. There is\n linear atelectasis in the left lower lung. There is no definite effusion. \n There is no pneumothorax. \n \n The heart size is enlarged, the mediastinal contours appear grossly\n unremarkable on this portable film.\n \n IMPRESSION:\n 1. Bilateral airspace opacity consistent with lobar pneumonia.\n \n 2. Nodular opacity in the left lung apex, recommend attention on followup.\n \n 3. Moderate cardiomegaly.\n', ' FINAL REPORT\n SINGLE FRONTAL VIEW OF THE CHEST\n \n REASON FOR EXAM: Pneumonia, bacteremia, intubated patient.\n \n Comparison is made to prior study performed a day earlier.\n \n Lines and tubes are in unchanged standard position. Multifocal\n consolidations in the right upper and lower lobes bilaterally left greater\n than right are unchanged. Severe cardiomegaly is stable. There are no new\n lung abnormalities. Probably small right pleural effusion is unchanged.\n', ' FINAL REPORT\n REASON FOR EXAMINATION: Evaluation of the patient with endocarditis,\n intubated.\n \n AP radiograph of the chest was reviewed in comparison to ___.\n \n The ET tube tip is 5 cm above the carina. The right internal jugular line tip\n is at the level of mid SVC. Cardiomegaly is unchanged, moderate to severe. \n The patient continues to be in mild pulmonary edema. Right upper lobe opacity\n appears to be unchanged, representing right upper lobe consolidation, better\n appreciated on the chest CT obtained on ___. Left basal consolidation\n is better appreciated on CT and obscured by the cardiomegaly and pleural\n effusion on the current radiograph.\n', ' PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:38 AM\n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n ______________________________________________________________________________\n FINAL REPORT\n HISTORY: ___-year-old male with endocarditis and intubated.\n \n STUDY: Portable AP semi-upright chest radiograph.\n \n COMPARISON: ___.\n \n FINDINGS: The endotracheal tube tip sits 5 cm above the carina. A left-sided\n IJ central venous catheter tip sits in the left brachiocephalic vein. The\n right-sided IJ central venous catheter tip sits in the upper SVC. The heart\n size is large but stable. The mediastinal contours are within normal limits. \n There continue to be bibasilar and perihilar opacities as well as a more\n rounded confluent opacity in the right upper lung. These findings likely\n represent increased pulmonary edema as well as right upper and lower lobe\n consolidations. Retrocardiac opacity is also compatible with a left lower\n lobe consolidation. The costophrenic angles are excluded from the study\n limiting assessment for subtle pleural effusion. There is no large\n pneumothorax.\n \n IMPRESSION: \n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n', ' WET READ: ___ ___ ___ 2:09 PM\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n ______________________________________________________________________________\n FINAL REPORT\n INDICATION: Status post AVR, question pneumothorax after chest tube removal.\n \n COMPARISON: Chest radiograph on ___.\n \n FINDINGS: One portable AP view of the chest. The Swan-Ganz catheter through\n a right internal jugular approach ends in the region of the main pulmonary\n artery. The left internal jugular catheter ends in the left brachiocephalic\n vein just before the SVC. Endotracheal tube ends 6 cm from the carina. The\n previously seen moderate-to-severe pulmonary edema has slightly improved. The\n right upper lobe parenchymal opacity is unchanged. Mild cardiomegaly is\n stable. Mediastinal and hilar contours are normal. No pneumothorax.\n \n IMPRESSION:\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n', ' FINAL REPORT\n CHEST RADIOGRAPH \n \n INDICATION: Evaluation for pleural effusions.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous radiograph, the right-sided pleural\n effusion has minimally decreased. On the left, however, the effusion has\n substantially increased and leads to a near total opacification of the left\n hemithorax. Subsequently, severe atelectatic changes are present.\n \n The Swan-Ganz catheter has been removed, the right internal jugular vein\n catheter has also been removed, a nasogastric tube, the endotracheal tube and\n a venous introduction sheath remains in situ.\n', ' FINAL REPORT\n CHEST RADIOGRAPH\n \n INDICATION: Extubation, evaluation for pleural effusion.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous exam, the patient has been extubated\n and the nasogastric tube has been removed. The extent of the pre-existing\n pleural effusions have bilaterally increased. There is moderate-to-extensive\n cardiomegaly with bilateral extensive areas of atelectasis. Mild-to-moderate\n fluid overload. No focal parenchymal opacity suggest pneumonia.\n', ' FINAL REPORT\n CHEST RADIOGRAPH\n \n INDICATION: PICC line placement.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous radiograph, the right venous\n introduction sheath has been removed and a left PICC line has been inserted. \n The course of the line is unremarkable, the tip of the line projects over the\n mid SVC. There is no evidence of complications, notably no pneumothorax.\n \n The pre-existing bilateral parenchymal opacities, mostly caused by pleural\n effusions and subsequent atelectasis, have decreased in extent.\n']

Status post AVR, assess for effusion

FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with hypoxia, recent cough TECHNIQUE: Upright AP view of the chest COMPARISON: Chest radiograph ___ at 14:51, CT chest ___ FINDINGS: Right-sided Port-A-Cath tip terminates at the junction of the SVC and right atrium. Patient is status post median sternotomy and aortic valve replacement. Lung volumes are low with mild enlargement of the cardiac silhouette, unchanged. Mediastinal and hilar contours are similar. There is mild pulmonary edema, slightly improved in the interval. Patchy opacities in the lung bases may reflect areas of atelectasis, but infection particularly in the left lung base cannot be completely excluded. No pleural effusion or pneumothorax is demonstrated. Elevation of the left hemidiaphragm is again noted. No acute osseous abnormality is visualized. IMPRESSION: Slight improvement in mild pulmonary edema. Patchy opacities in the lung bases may reflect atelectasis, but infection particularly in the left lung base cannot be completely excluded.

mimic-cxr-jpg_2.0.0_files_p11_p11022245_s50126222_0ae07ada-41d03c2a-ec74ae48-d0c17cec-343ae6fa.jpg

[(4, 223, 17, 31), (4, 222, 13, 2), (4, 221, 7, 36), (4, 220, 13, 37), (4, 218, 8, 3), (4, 216, 3, 24), (4, 215, 9, 15), (4, 215, 5, 25), (4, 213, 7, 56), (4, 211, 2, 31), (0, 26, 23, 22), (0, 26, 22, 44), (0, 26, 13, 4)]

[' FINAL REPORT\n CLINICAL INFORMATION: ___-year-old male with CHF versus pneumonia, intubated.\n \n COMPARISON: None.\n \n FINDINGS: Portable frontal chest radiographs demonstrate intubated patient,\n the tip of the endotracheal tube is positioned 4.1 cm from the level of the\n carina. An orogastric tube is in place and is coiled within the fundus of the\n stomach. There is airspace opacification of the right lung with relative\n sparing of the apex, as well as basilar left lung opacity. Linear atelectasis\n is seen in the right mid lung. The left lung is relatively clear. A focal\n nodular opacity is seen in the left upper lung measuring 8 mm. There is\n linear atelectasis in the left lower lung. There is no definite effusion. \n There is no pneumothorax. \n \n The heart size is enlarged, the mediastinal contours appear grossly\n unremarkable on this portable film.\n \n IMPRESSION:\n 1. Bilateral airspace opacity consistent with lobar pneumonia.\n \n 2. Nodular opacity in the left lung apex, recommend attention on followup.\n \n 3. Moderate cardiomegaly.\n', ' FINAL REPORT\n SINGLE FRONTAL VIEW OF THE CHEST\n \n REASON FOR EXAM: Pneumonia, bacteremia, intubated patient.\n \n Comparison is made to prior study performed a day earlier.\n \n Lines and tubes are in unchanged standard position. Multifocal\n consolidations in the right upper and lower lobes bilaterally left greater\n than right are unchanged. Severe cardiomegaly is stable. There are no new\n lung abnormalities. Probably small right pleural effusion is unchanged.\n', ' FINAL REPORT\n REASON FOR EXAMINATION: Evaluation of the patient with endocarditis,\n intubated.\n \n AP radiograph of the chest was reviewed in comparison to ___.\n \n The ET tube tip is 5 cm above the carina. The right internal jugular line tip\n is at the level of mid SVC. Cardiomegaly is unchanged, moderate to severe. \n The patient continues to be in mild pulmonary edema. Right upper lobe opacity\n appears to be unchanged, representing right upper lobe consolidation, better\n appreciated on the chest CT obtained on ___. Left basal consolidation\n is better appreciated on CT and obscured by the cardiomegaly and pleural\n effusion on the current radiograph.\n', ' PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:38 AM\n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n ______________________________________________________________________________\n FINAL REPORT\n HISTORY: ___-year-old male with endocarditis and intubated.\n \n STUDY: Portable AP semi-upright chest radiograph.\n \n COMPARISON: ___.\n \n FINDINGS: The endotracheal tube tip sits 5 cm above the carina. A left-sided\n IJ central venous catheter tip sits in the left brachiocephalic vein. The\n right-sided IJ central venous catheter tip sits in the upper SVC. The heart\n size is large but stable. The mediastinal contours are within normal limits. \n There continue to be bibasilar and perihilar opacities as well as a more\n rounded confluent opacity in the right upper lung. These findings likely\n represent increased pulmonary edema as well as right upper and lower lobe\n consolidations. Retrocardiac opacity is also compatible with a left lower\n lobe consolidation. The costophrenic angles are excluded from the study\n limiting assessment for subtle pleural effusion. There is no large\n pneumothorax.\n \n IMPRESSION: \n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n', ' WET READ: ___ ___ ___ 2:09 PM\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n ______________________________________________________________________________\n FINAL REPORT\n INDICATION: Status post AVR, question pneumothorax after chest tube removal.\n \n COMPARISON: Chest radiograph on ___.\n \n FINDINGS: One portable AP view of the chest. The Swan-Ganz catheter through\n a right internal jugular approach ends in the region of the main pulmonary\n artery. The left internal jugular catheter ends in the left brachiocephalic\n vein just before the SVC. Endotracheal tube ends 6 cm from the carina. The\n previously seen moderate-to-severe pulmonary edema has slightly improved. The\n right upper lobe parenchymal opacity is unchanged. Mild cardiomegaly is\n stable. Mediastinal and hilar contours are normal. No pneumothorax.\n \n IMPRESSION:\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n', ' FINAL REPORT\n CHEST RADIOGRAPH \n \n INDICATION: Evaluation for pleural effusions.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous radiograph, the right-sided pleural\n effusion has minimally decreased. On the left, however, the effusion has\n substantially increased and leads to a near total opacification of the left\n hemithorax. Subsequently, severe atelectatic changes are present.\n \n The Swan-Ganz catheter has been removed, the right internal jugular vein\n catheter has also been removed, a nasogastric tube, the endotracheal tube and\n a venous introduction sheath remains in situ.\n', ' FINAL REPORT\n CHEST RADIOGRAPH\n \n INDICATION: Extubation, evaluation for pleural effusion.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous exam, the patient has been extubated\n and the nasogastric tube has been removed. The extent of the pre-existing\n pleural effusions have bilaterally increased. There is moderate-to-extensive\n cardiomegaly with bilateral extensive areas of atelectasis. Mild-to-moderate\n fluid overload. No focal parenchymal opacity suggest pneumonia.\n', ' FINAL REPORT\n CHEST RADIOGRAPH\n \n INDICATION: PICC line placement.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous radiograph, the right venous\n introduction sheath has been removed and a left PICC line has been inserted. \n The course of the line is unremarkable, the tip of the line projects over the\n mid SVC. There is no evidence of complications, notably no pneumothorax.\n \n The pre-existing bilateral parenchymal opacities, mostly caused by pleural\n effusions and subsequent atelectasis, have decreased in extent.\n', ' FINAL REPORT\n INDICATION: Status post AVR, assess for effusion.\n \n TECHNIQUE: PA and Lateral radiographs\n \n COMPARISONS: Multiple priors most recently ___\n \n FINDINGS: Rounded right midlung opacity compatible with previously described\n septic embolus is decreased in size from the prior study. Left midlung rounded\n consolidation is more conspicuous than previously seen. Potential etiologies\n include developing pneumonia, additional septic embolus or collection of\n fissural fluid, though the lateral argues against the latter. \n \n Small left pleural effusion is noted along with left greater than right\n bibasilar atelectasis. Marked enlargement of the cardiac silhouette is\n similar to the study from ___ though notably larger than the immediate\n post-procedure study from ___. Left PICC is in satisfactory position in the\n superior cavoatrial junction. Median sternotomy wires and aortic valve\n replacement are also noted.\n \n IMPRESSION: \n 1. More conspicuous left midlung opacity concerning for developing pneumonia\n or septic embolus. \n 2. Improved small left pleural effusion and left greater than right bibasilar\n atelectasis. \n \n Findings were discussed by telephone with ___, NP, by Dr. ___ on\n ___ at ___.\n', ' FINAL REPORT\n INDICATION: Status post AVR, assess left lung opacity.\n \n TECHNIQUE: PA and lateral radiographs of the chest.\n \n COMPARISON: Chest radiograph from ___.\n \n FINDINGS: Rounded bilateral mid lung opacities are again seen, grossly\n unchanged and likely reflect consolidative infectious process given history of\n septic emboli. There is unchanged bibasilar opacification, which is likely\n atelectasis with left greater than right effusions. Cardiac silhouette is\n markedly enlarged, similar to the most recent prior. Left PICC terminates in\n the cavoatrial junction. Median sternotomy wires are intact.\n \n IMPRESSION:\n 1. Unchanged bilateral mid lung opacities likely reflect infectious process\n given history of septic emboli.\n 2. Unchanged or slightly increased left greater than right pleural effusion\n and associated atelectasis.\n', ' FINAL REPORT\n EXAMINATION: CHEST (PORTABLE AP)\n \n INDICATION: ___M with largyneal cancer, inc WOB // PNA\n \n COMPARISON: Prior exam from earlier today.\n \n FINDINGS: \n \n AP portable semi upright view of the chest.\n \n Lung volumes are low limiting assessment. There is increased bibasilar\n atelectasis and bronchovascular crowding. Overall cardiomediastinal\n silhouette is unchanged. The right upper extremity access PICC line appears\n in unchanged position extending to the level of the cavoatrial junction. Mild\n congestion is difficult to exclude in the correct clinical setting. No overt\n signs of edema.\n \n IMPRESSION: \n \n Increasing bibasilar atelectasis. Possible mild pulmonary vascular\n congestion.\n', ' FINAL REPORT\n EXAMINATION: CHEST (PORTABLE AP)\n \n INDICATION: History: ___M with ett tube, pls eval placement //\n \n COMPARISON: Prior exam performed earlier today.\n \n FINDINGS: \n \n AP portable upright view of the chest. There has been interval intubation\n with the tip of the endotracheal tube positioned 3.3 cm above the carina. The\n right upper extremity access PICC line is unchanged. There is increasing\n bibasilar atelectasis.\n \n IMPRESSION: \n \n As above.\n', ' FINAL REPORT\n EXAMINATION: CHEST (PORTABLE AP)\n \n INDICATION: ___ year old man with laryngeal cancer and acute respiratory\n failure in context of opiod use // ET tube position confirmation ET tube\n position confirmation\n \n IMPRESSION: \n \n Comparison to ___, 18:21. The position of the right PICC line and of\n the endotracheal tube are stable and correct. The tip of the endotracheal\n tube projects approximately 5 cm above the carina. Increasing areas of right\n basal and left retrocardiac atelectasis. Otherwise unchanged radiographic\n appearance of the lung and of the heart.\n']

History: ___M with hypoxia, recent cough

FINAL REPORT EXAMINATION: Chest radiograph INDICATION: ___ year old man with hypotension of unknown origin // rule out pna or pneumonitis TECHNIQUE: Portable AP view of the chest COMPARISON: AP view of the chest from ___ at 10:53 AM FINDINGS: No significant change within the airspace opacity at the left mid lung zone. Again seen medial right base airspace opacity, unchanged Right IJ Port-A-Cath is unchanged in position. Sternotomy wires. Cardiac valve replacement is noted. Heart is enlarged, unchanged. Again seen prominent bilateral hilar in haziness the pulmonary vascular consistent pulmonary vascular congestion. This preliminary report was reviewed with Dr. ___, ___ radiologist. IMPRESSION: No change in the left midlung airspace opacity or in the airspace opacity at the right medial lung base

mimic-cxr-jpg_2.0.0_files_p11_p11022245_s52391187_df81aa63-051ce829-f15a7ba0-391d8fb4-f81549e5.jpg

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[' FINAL REPORT\n CLINICAL INFORMATION: ___-year-old male with CHF versus pneumonia, intubated.\n \n COMPARISON: None.\n \n FINDINGS: Portable frontal chest radiographs demonstrate intubated patient,\n the tip of the endotracheal tube is positioned 4.1 cm from the level of the\n carina. An orogastric tube is in place and is coiled within the fundus of the\n stomach. There is airspace opacification of the right lung with relative\n sparing of the apex, as well as basilar left lung opacity. Linear atelectasis\n is seen in the right mid lung. The left lung is relatively clear. A focal\n nodular opacity is seen in the left upper lung measuring 8 mm. There is\n linear atelectasis in the left lower lung. There is no definite effusion. \n There is no pneumothorax. \n \n The heart size is enlarged, the mediastinal contours appear grossly\n unremarkable on this portable film.\n \n IMPRESSION:\n 1. Bilateral airspace opacity consistent with lobar pneumonia.\n \n 2. Nodular opacity in the left lung apex, recommend attention on followup.\n \n 3. Moderate cardiomegaly.\n', ' FINAL REPORT\n SINGLE FRONTAL VIEW OF THE CHEST\n \n REASON FOR EXAM: Pneumonia, bacteremia, intubated patient.\n \n Comparison is made to prior study performed a day earlier.\n \n Lines and tubes are in unchanged standard position. Multifocal\n consolidations in the right upper and lower lobes bilaterally left greater\n than right are unchanged. Severe cardiomegaly is stable. There are no new\n lung abnormalities. Probably small right pleural effusion is unchanged.\n', ' FINAL REPORT\n REASON FOR EXAMINATION: Evaluation of the patient with endocarditis,\n intubated.\n \n AP radiograph of the chest was reviewed in comparison to ___.\n \n The ET tube tip is 5 cm above the carina. The right internal jugular line tip\n is at the level of mid SVC. Cardiomegaly is unchanged, moderate to severe. \n The patient continues to be in mild pulmonary edema. Right upper lobe opacity\n appears to be unchanged, representing right upper lobe consolidation, better\n appreciated on the chest CT obtained on ___. Left basal consolidation\n is better appreciated on CT and obscured by the cardiomegaly and pleural\n effusion on the current radiograph.\n', ' PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:38 AM\n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n ______________________________________________________________________________\n FINAL REPORT\n HISTORY: ___-year-old male with endocarditis and intubated.\n \n STUDY: Portable AP semi-upright chest radiograph.\n \n COMPARISON: ___.\n \n FINDINGS: The endotracheal tube tip sits 5 cm above the carina. A left-sided\n IJ central venous catheter tip sits in the left brachiocephalic vein. The\n right-sided IJ central venous catheter tip sits in the upper SVC. The heart\n size is large but stable. The mediastinal contours are within normal limits. \n There continue to be bibasilar and perihilar opacities as well as a more\n rounded confluent opacity in the right upper lung. These findings likely\n represent increased pulmonary edema as well as right upper and lower lobe\n consolidations. Retrocardiac opacity is also compatible with a left lower\n lobe consolidation. The costophrenic angles are excluded from the study\n limiting assessment for subtle pleural effusion. There is no large\n pneumothorax.\n \n IMPRESSION: \n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n', ' WET READ: ___ ___ ___ 2:09 PM\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n ______________________________________________________________________________\n FINAL REPORT\n INDICATION: Status post AVR, question pneumothorax after chest tube removal.\n \n COMPARISON: Chest radiograph on ___.\n \n FINDINGS: One portable AP view of the chest. The Swan-Ganz catheter through\n a right internal jugular approach ends in the region of the main pulmonary\n artery. The left internal jugular catheter ends in the left brachiocephalic\n vein just before the SVC. Endotracheal tube ends 6 cm from the carina. The\n previously seen moderate-to-severe pulmonary edema has slightly improved. The\n right upper lobe parenchymal opacity is unchanged. Mild cardiomegaly is\n stable. Mediastinal and hilar contours are normal. No pneumothorax.\n \n IMPRESSION:\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n', ' FINAL REPORT\n CHEST RADIOGRAPH \n \n INDICATION: Evaluation for pleural effusions.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous radiograph, the right-sided pleural\n effusion has minimally decreased. On the left, however, the effusion has\n substantially increased and leads to a near total opacification of the left\n hemithorax. Subsequently, severe atelectatic changes are present.\n \n The Swan-Ganz catheter has been removed, the right internal jugular vein\n catheter has also been removed, a nasogastric tube, the endotracheal tube and\n a venous introduction sheath remains in situ.\n', ' FINAL REPORT\n CHEST RADIOGRAPH\n \n INDICATION: Extubation, evaluation for pleural effusion.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous exam, the patient has been extubated\n and the nasogastric tube has been removed. The extent of the pre-existing\n pleural effusions have bilaterally increased. There is moderate-to-extensive\n cardiomegaly with bilateral extensive areas of atelectasis. Mild-to-moderate\n fluid overload. No focal parenchymal opacity suggest pneumonia.\n', ' FINAL REPORT\n CHEST RADIOGRAPH\n \n INDICATION: PICC line placement.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous radiograph, the right venous\n introduction sheath has been removed and a left PICC line has been inserted. \n The course of the line is unremarkable, the tip of the line projects over the\n mid SVC. There is no evidence of complications, notably no pneumothorax.\n \n The pre-existing bilateral parenchymal opacities, mostly caused by pleural\n effusions and subsequent atelectasis, have decreased in extent.\n', ' FINAL REPORT\n INDICATION: Status post AVR, assess for effusion.\n \n TECHNIQUE: PA and Lateral radiographs\n \n COMPARISONS: Multiple priors most recently ___\n \n FINDINGS: Rounded right midlung opacity compatible with previously described\n septic embolus is decreased in size from the prior study. Left midlung rounded\n consolidation is more conspicuous than previously seen. Potential etiologies\n include developing pneumonia, additional septic embolus or collection of\n fissural fluid, though the lateral argues against the latter. \n \n Small left pleural effusion is noted along with left greater than right\n bibasilar atelectasis. Marked enlargement of the cardiac silhouette is\n similar to the study from ___ though notably larger than the immediate\n post-procedure study from ___. Left PICC is in satisfactory position in the\n superior cavoatrial junction. Median sternotomy wires and aortic valve\n replacement are also noted.\n \n IMPRESSION: \n 1. More conspicuous left midlung opacity concerning for developing pneumonia\n or septic embolus. \n 2. Improved small left pleural effusion and left greater than right bibasilar\n atelectasis. \n \n Findings were discussed by telephone with ___, NP, by Dr. ___ on\n ___ at ___.\n', ' FINAL REPORT\n INDICATION: Status post AVR, assess left lung opacity.\n \n TECHNIQUE: PA and lateral radiographs of the chest.\n \n COMPARISON: Chest radiograph from ___.\n \n FINDINGS: Rounded bilateral mid lung opacities are again seen, grossly\n unchanged and likely reflect consolidative infectious process given history of\n septic emboli. There is unchanged bibasilar opacification, which is likely\n atelectasis with left greater than right effusions. Cardiac silhouette is\n markedly enlarged, similar to the most recent prior. Left PICC terminates in\n the cavoatrial junction. Median sternotomy wires are intact.\n \n IMPRESSION:\n 1. Unchanged bilateral mid lung opacities likely reflect infectious process\n given history of septic emboli.\n 2. Unchanged or slightly increased left greater than right pleural effusion\n and associated atelectasis.\n', ' FINAL REPORT\n EXAMINATION: CHEST (PORTABLE AP)\n \n INDICATION: ___M with largyneal cancer, inc WOB // PNA\n \n COMPARISON: Prior exam from earlier today.\n \n FINDINGS: \n \n AP portable semi upright view of the chest.\n \n Lung volumes are low limiting assessment. There is increased bibasilar\n atelectasis and bronchovascular crowding. Overall cardiomediastinal\n silhouette is unchanged. The right upper extremity access PICC line appears\n in unchanged position extending to the level of the cavoatrial junction. Mild\n congestion is difficult to exclude in the correct clinical setting. No overt\n signs of edema.\n \n IMPRESSION: \n \n Increasing bibasilar atelectasis. Possible mild pulmonary vascular\n congestion.\n', ' FINAL REPORT\n EXAMINATION: CHEST (PORTABLE AP)\n \n INDICATION: History: ___M with ett tube, pls eval placement //\n \n COMPARISON: Prior exam performed earlier today.\n \n FINDINGS: \n \n AP portable upright view of the chest. There has been interval intubation\n with the tip of the endotracheal tube positioned 3.3 cm above the carina. The\n right upper extremity access PICC line is unchanged. There is increasing\n bibasilar atelectasis.\n \n IMPRESSION: \n \n As above.\n', ' FINAL REPORT\n EXAMINATION: CHEST (PORTABLE AP)\n \n INDICATION: ___ year old man with laryngeal cancer and acute respiratory\n failure in context of opiod use // ET tube position confirmation ET tube\n position confirmation\n \n IMPRESSION: \n \n Comparison to ___, 18:21. The position of the right PICC line and of\n the endotracheal tube are stable and correct. The tip of the endotracheal\n tube projects approximately 5 cm above the carina. Increasing areas of right\n basal and left retrocardiac atelectasis. Otherwise unchanged radiographic\n appearance of the lung and of the heart.\n', ' FINAL REPORT\n EXAMINATION: CHEST (PORTABLE AP)\n \n INDICATION: History: ___M with hypoxia, recent cough\n \n TECHNIQUE: Upright AP view of the chest\n \n COMPARISON: Chest radiograph ___ at 14:51, CT chest ___\n \n FINDINGS: \n \n Right-sided Port-A-Cath tip terminates at the junction of the SVC and right\n atrium. Patient is status post median sternotomy and aortic valve\n replacement. Lung volumes are low with mild enlargement of the cardiac\n silhouette, unchanged. Mediastinal and hilar contours are similar. There is\n mild pulmonary edema, slightly improved in the interval. Patchy opacities in\n the lung bases may reflect areas of atelectasis, but infection particularly in\n the left lung base cannot be completely excluded. No pleural effusion or\n pneumothorax is demonstrated. Elevation of the left hemidiaphragm is again\n noted. No acute osseous abnormality is visualized.\n \n IMPRESSION: \n \n Slight improvement in mild pulmonary edema. Patchy opacities in the lung\n bases may reflect atelectasis, but infection particularly in the left lung\n base cannot be completely excluded.\n']

___ year old man with hypotension of unknown origin // rule out pna or pneumonitis

FINAL REPORT INDICATION: Status post AVR, assess left lung opacity. TECHNIQUE: PA and lateral radiographs of the chest. COMPARISON: Chest radiograph from ___. FINDINGS: Rounded bilateral mid lung opacities are again seen, grossly unchanged and likely reflect consolidative infectious process given history of septic emboli. There is unchanged bibasilar opacification, which is likely atelectasis with left greater than right effusions. Cardiac silhouette is markedly enlarged, similar to the most recent prior. Left PICC terminates in the cavoatrial junction. Median sternotomy wires are intact. IMPRESSION: 1. Unchanged bilateral mid lung opacities likely reflect infectious process given history of septic emboli. 2. Unchanged or slightly increased left greater than right pleural effusion and associated atelectasis.

mimic-cxr-jpg_2.0.0_files_p11_p11022245_s58274962_f7ba6691-53545537-20c8b2dc-79dbd392-36f05d15.jpg

[(0, 12, 15, 0), (0, 11, 10, 31), (0, 10, 5, 5), (0, 9, 11, 6), (0, 7, 5, 32), (0, 5, 0, 53), (0, 4, 6, 44), (0, 4, 2, 54), (0, 2, 5, 25)]

[' FINAL REPORT\n CLINICAL INFORMATION: ___-year-old male with CHF versus pneumonia, intubated.\n \n COMPARISON: None.\n \n FINDINGS: Portable frontal chest radiographs demonstrate intubated patient,\n the tip of the endotracheal tube is positioned 4.1 cm from the level of the\n carina. An orogastric tube is in place and is coiled within the fundus of the\n stomach. There is airspace opacification of the right lung with relative\n sparing of the apex, as well as basilar left lung opacity. Linear atelectasis\n is seen in the right mid lung. The left lung is relatively clear. A focal\n nodular opacity is seen in the left upper lung measuring 8 mm. There is\n linear atelectasis in the left lower lung. There is no definite effusion. \n There is no pneumothorax. \n \n The heart size is enlarged, the mediastinal contours appear grossly\n unremarkable on this portable film.\n \n IMPRESSION:\n 1. Bilateral airspace opacity consistent with lobar pneumonia.\n \n 2. Nodular opacity in the left lung apex, recommend attention on followup.\n \n 3. Moderate cardiomegaly.\n', ' FINAL REPORT\n SINGLE FRONTAL VIEW OF THE CHEST\n \n REASON FOR EXAM: Pneumonia, bacteremia, intubated patient.\n \n Comparison is made to prior study performed a day earlier.\n \n Lines and tubes are in unchanged standard position. Multifocal\n consolidations in the right upper and lower lobes bilaterally left greater\n than right are unchanged. Severe cardiomegaly is stable. There are no new\n lung abnormalities. Probably small right pleural effusion is unchanged.\n', ' FINAL REPORT\n REASON FOR EXAMINATION: Evaluation of the patient with endocarditis,\n intubated.\n \n AP radiograph of the chest was reviewed in comparison to ___.\n \n The ET tube tip is 5 cm above the carina. The right internal jugular line tip\n is at the level of mid SVC. Cardiomegaly is unchanged, moderate to severe. \n The patient continues to be in mild pulmonary edema. Right upper lobe opacity\n appears to be unchanged, representing right upper lobe consolidation, better\n appreciated on the chest CT obtained on ___. Left basal consolidation\n is better appreciated on CT and obscured by the cardiomegaly and pleural\n effusion on the current radiograph.\n', ' PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:38 AM\n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n ______________________________________________________________________________\n FINAL REPORT\n HISTORY: ___-year-old male with endocarditis and intubated.\n \n STUDY: Portable AP semi-upright chest radiograph.\n \n COMPARISON: ___.\n \n FINDINGS: The endotracheal tube tip sits 5 cm above the carina. A left-sided\n IJ central venous catheter tip sits in the left brachiocephalic vein. The\n right-sided IJ central venous catheter tip sits in the upper SVC. The heart\n size is large but stable. The mediastinal contours are within normal limits. \n There continue to be bibasilar and perihilar opacities as well as a more\n rounded confluent opacity in the right upper lung. These findings likely\n represent increased pulmonary edema as well as right upper and lower lobe\n consolidations. Retrocardiac opacity is also compatible with a left lower\n lobe consolidation. The costophrenic angles are excluded from the study\n limiting assessment for subtle pleural effusion. There is no large\n pneumothorax.\n \n IMPRESSION: \n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n', ' WET READ: ___ ___ ___ 2:09 PM\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n ______________________________________________________________________________\n FINAL REPORT\n INDICATION: Status post AVR, question pneumothorax after chest tube removal.\n \n COMPARISON: Chest radiograph on ___.\n \n FINDINGS: One portable AP view of the chest. The Swan-Ganz catheter through\n a right internal jugular approach ends in the region of the main pulmonary\n artery. The left internal jugular catheter ends in the left brachiocephalic\n vein just before the SVC. Endotracheal tube ends 6 cm from the carina. The\n previously seen moderate-to-severe pulmonary edema has slightly improved. The\n right upper lobe parenchymal opacity is unchanged. Mild cardiomegaly is\n stable. Mediastinal and hilar contours are normal. No pneumothorax.\n \n IMPRESSION:\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n', ' FINAL REPORT\n CHEST RADIOGRAPH \n \n INDICATION: Evaluation for pleural effusions.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous radiograph, the right-sided pleural\n effusion has minimally decreased. On the left, however, the effusion has\n substantially increased and leads to a near total opacification of the left\n hemithorax. Subsequently, severe atelectatic changes are present.\n \n The Swan-Ganz catheter has been removed, the right internal jugular vein\n catheter has also been removed, a nasogastric tube, the endotracheal tube and\n a venous introduction sheath remains in situ.\n', ' FINAL REPORT\n CHEST RADIOGRAPH\n \n INDICATION: Extubation, evaluation for pleural effusion.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous exam, the patient has been extubated\n and the nasogastric tube has been removed. The extent of the pre-existing\n pleural effusions have bilaterally increased. There is moderate-to-extensive\n cardiomegaly with bilateral extensive areas of atelectasis. Mild-to-moderate\n fluid overload. No focal parenchymal opacity suggest pneumonia.\n', ' FINAL REPORT\n CHEST RADIOGRAPH\n \n INDICATION: PICC line placement.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous radiograph, the right venous\n introduction sheath has been removed and a left PICC line has been inserted. \n The course of the line is unremarkable, the tip of the line projects over the\n mid SVC. There is no evidence of complications, notably no pneumothorax.\n \n The pre-existing bilateral parenchymal opacities, mostly caused by pleural\n effusions and subsequent atelectasis, have decreased in extent.\n', ' FINAL REPORT\n INDICATION: Status post AVR, assess for effusion.\n \n TECHNIQUE: PA and Lateral radiographs\n \n COMPARISONS: Multiple priors most recently ___\n \n FINDINGS: Rounded right midlung opacity compatible with previously described\n septic embolus is decreased in size from the prior study. Left midlung rounded\n consolidation is more conspicuous than previously seen. Potential etiologies\n include developing pneumonia, additional septic embolus or collection of\n fissural fluid, though the lateral argues against the latter. \n \n Small left pleural effusion is noted along with left greater than right\n bibasilar atelectasis. Marked enlargement of the cardiac silhouette is\n similar to the study from ___ though notably larger than the immediate\n post-procedure study from ___. Left PICC is in satisfactory position in the\n superior cavoatrial junction. Median sternotomy wires and aortic valve\n replacement are also noted.\n \n IMPRESSION: \n 1. More conspicuous left midlung opacity concerning for developing pneumonia\n or septic embolus. \n 2. Improved small left pleural effusion and left greater than right bibasilar\n atelectasis. \n \n Findings were discussed by telephone with ___, NP, by Dr. ___ on\n ___ at ___.\n']

Status post AVR, assess left lung opacity.

FINAL REPORT CHEST RADIOGRAPH INDICATION: PICC line placement. COMPARISON: ___. FINDINGS: As compared to the previous radiograph, the right venous introduction sheath has been removed and a left PICC line has been inserted. The course of the line is unremarkable, the tip of the line projects over the mid SVC. There is no evidence of complications, notably no pneumothorax. The pre-existing bilateral parenchymal opacities, mostly caused by pleural effusions and subsequent atelectasis, have decreased in extent.

mimic-cxr-jpg_2.0.0_files_p11_p11022245_s56258422_848b0d7f-e95a86d4-0c40c933-7b2dc937-ac3d74c6.jpg

[(0, 8, 12, 6), (0, 7, 7, 37), (0, 6, 2, 11), (0, 5, 8, 12), (0, 3, 2, 38), (0, 0, 21, 59), (0, 0, 3, 50)]

[' FINAL REPORT\n CLINICAL INFORMATION: ___-year-old male with CHF versus pneumonia, intubated.\n \n COMPARISON: None.\n \n FINDINGS: Portable frontal chest radiographs demonstrate intubated patient,\n the tip of the endotracheal tube is positioned 4.1 cm from the level of the\n carina. An orogastric tube is in place and is coiled within the fundus of the\n stomach. There is airspace opacification of the right lung with relative\n sparing of the apex, as well as basilar left lung opacity. Linear atelectasis\n is seen in the right mid lung. The left lung is relatively clear. A focal\n nodular opacity is seen in the left upper lung measuring 8 mm. There is\n linear atelectasis in the left lower lung. There is no definite effusion. \n There is no pneumothorax. \n \n The heart size is enlarged, the mediastinal contours appear grossly\n unremarkable on this portable film.\n \n IMPRESSION:\n 1. Bilateral airspace opacity consistent with lobar pneumonia.\n \n 2. Nodular opacity in the left lung apex, recommend attention on followup.\n \n 3. Moderate cardiomegaly.\n', ' FINAL REPORT\n SINGLE FRONTAL VIEW OF THE CHEST\n \n REASON FOR EXAM: Pneumonia, bacteremia, intubated patient.\n \n Comparison is made to prior study performed a day earlier.\n \n Lines and tubes are in unchanged standard position. Multifocal\n consolidations in the right upper and lower lobes bilaterally left greater\n than right are unchanged. Severe cardiomegaly is stable. There are no new\n lung abnormalities. Probably small right pleural effusion is unchanged.\n', ' FINAL REPORT\n REASON FOR EXAMINATION: Evaluation of the patient with endocarditis,\n intubated.\n \n AP radiograph of the chest was reviewed in comparison to ___.\n \n The ET tube tip is 5 cm above the carina. The right internal jugular line tip\n is at the level of mid SVC. Cardiomegaly is unchanged, moderate to severe. \n The patient continues to be in mild pulmonary edema. Right upper lobe opacity\n appears to be unchanged, representing right upper lobe consolidation, better\n appreciated on the chest CT obtained on ___. Left basal consolidation\n is better appreciated on CT and obscured by the cardiomegaly and pleural\n effusion on the current radiograph.\n', ' PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:38 AM\n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n ______________________________________________________________________________\n FINAL REPORT\n HISTORY: ___-year-old male with endocarditis and intubated.\n \n STUDY: Portable AP semi-upright chest radiograph.\n \n COMPARISON: ___.\n \n FINDINGS: The endotracheal tube tip sits 5 cm above the carina. A left-sided\n IJ central venous catheter tip sits in the left brachiocephalic vein. The\n right-sided IJ central venous catheter tip sits in the upper SVC. The heart\n size is large but stable. The mediastinal contours are within normal limits. \n There continue to be bibasilar and perihilar opacities as well as a more\n rounded confluent opacity in the right upper lung. These findings likely\n represent increased pulmonary edema as well as right upper and lower lobe\n consolidations. Retrocardiac opacity is also compatible with a left lower\n lobe consolidation. The costophrenic angles are excluded from the study\n limiting assessment for subtle pleural effusion. There is no large\n pneumothorax.\n \n IMPRESSION: \n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n', ' WET READ: ___ ___ ___ 2:09 PM\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n ______________________________________________________________________________\n FINAL REPORT\n INDICATION: Status post AVR, question pneumothorax after chest tube removal.\n \n COMPARISON: Chest radiograph on ___.\n \n FINDINGS: One portable AP view of the chest. The Swan-Ganz catheter through\n a right internal jugular approach ends in the region of the main pulmonary\n artery. The left internal jugular catheter ends in the left brachiocephalic\n vein just before the SVC. Endotracheal tube ends 6 cm from the carina. The\n previously seen moderate-to-severe pulmonary edema has slightly improved. The\n right upper lobe parenchymal opacity is unchanged. Mild cardiomegaly is\n stable. Mediastinal and hilar contours are normal. No pneumothorax.\n \n IMPRESSION:\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n', ' FINAL REPORT\n CHEST RADIOGRAPH \n \n INDICATION: Evaluation for pleural effusions.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous radiograph, the right-sided pleural\n effusion has minimally decreased. On the left, however, the effusion has\n substantially increased and leads to a near total opacification of the left\n hemithorax. Subsequently, severe atelectatic changes are present.\n \n The Swan-Ganz catheter has been removed, the right internal jugular vein\n catheter has also been removed, a nasogastric tube, the endotracheal tube and\n a venous introduction sheath remains in situ.\n', ' FINAL REPORT\n CHEST RADIOGRAPH\n \n INDICATION: Extubation, evaluation for pleural effusion.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous exam, the patient has been extubated\n and the nasogastric tube has been removed. The extent of the pre-existing\n pleural effusions have bilaterally increased. There is moderate-to-extensive\n cardiomegaly with bilateral extensive areas of atelectasis. Mild-to-moderate\n fluid overload. No focal parenchymal opacity suggest pneumonia.\n']

PICC line placement

FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___M with largyneal cancer, inc WOB // PNA COMPARISON: Prior exam from earlier today. FINDINGS: AP portable semi upright view of the chest. Lung volumes are low limiting assessment. There is increased bibasilar atelectasis and bronchovascular crowding. Overall cardiomediastinal silhouette is unchanged. The right upper extremity access PICC line appears in unchanged position extending to the level of the cavoatrial junction. Mild congestion is difficult to exclude in the correct clinical setting. No overt signs of edema. IMPRESSION: Increasing bibasilar atelectasis. Possible mild pulmonary vascular congestion.

mimic-cxr-jpg_2.0.0_files_p11_p11022245_s58402174_8d3d599d-c63f3e85-fcd2ddbe-2e931945-482b1161.jpg

[(4, 196, 18, 9), (4, 195, 13, 40), (4, 194, 8, 14), (4, 193, 14, 15), (4, 191, 8, 41), (4, 189, 4, 2), (4, 188, 9, 53), (4, 188, 6, 3), (4, 186, 8, 34), (4, 184, 3, 9)]

[' FINAL REPORT\n CLINICAL INFORMATION: ___-year-old male with CHF versus pneumonia, intubated.\n \n COMPARISON: None.\n \n FINDINGS: Portable frontal chest radiographs demonstrate intubated patient,\n the tip of the endotracheal tube is positioned 4.1 cm from the level of the\n carina. An orogastric tube is in place and is coiled within the fundus of the\n stomach. There is airspace opacification of the right lung with relative\n sparing of the apex, as well as basilar left lung opacity. Linear atelectasis\n is seen in the right mid lung. The left lung is relatively clear. A focal\n nodular opacity is seen in the left upper lung measuring 8 mm. There is\n linear atelectasis in the left lower lung. There is no definite effusion. \n There is no pneumothorax. \n \n The heart size is enlarged, the mediastinal contours appear grossly\n unremarkable on this portable film.\n \n IMPRESSION:\n 1. Bilateral airspace opacity consistent with lobar pneumonia.\n \n 2. Nodular opacity in the left lung apex, recommend attention on followup.\n \n 3. Moderate cardiomegaly.\n', ' FINAL REPORT\n SINGLE FRONTAL VIEW OF THE CHEST\n \n REASON FOR EXAM: Pneumonia, bacteremia, intubated patient.\n \n Comparison is made to prior study performed a day earlier.\n \n Lines and tubes are in unchanged standard position. Multifocal\n consolidations in the right upper and lower lobes bilaterally left greater\n than right are unchanged. Severe cardiomegaly is stable. There are no new\n lung abnormalities. Probably small right pleural effusion is unchanged.\n', ' FINAL REPORT\n REASON FOR EXAMINATION: Evaluation of the patient with endocarditis,\n intubated.\n \n AP radiograph of the chest was reviewed in comparison to ___.\n \n The ET tube tip is 5 cm above the carina. The right internal jugular line tip\n is at the level of mid SVC. Cardiomegaly is unchanged, moderate to severe. \n The patient continues to be in mild pulmonary edema. Right upper lobe opacity\n appears to be unchanged, representing right upper lobe consolidation, better\n appreciated on the chest CT obtained on ___. Left basal consolidation\n is better appreciated on CT and obscured by the cardiomegaly and pleural\n effusion on the current radiograph.\n', ' PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:38 AM\n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n ______________________________________________________________________________\n FINAL REPORT\n HISTORY: ___-year-old male with endocarditis and intubated.\n \n STUDY: Portable AP semi-upright chest radiograph.\n \n COMPARISON: ___.\n \n FINDINGS: The endotracheal tube tip sits 5 cm above the carina. A left-sided\n IJ central venous catheter tip sits in the left brachiocephalic vein. The\n right-sided IJ central venous catheter tip sits in the upper SVC. The heart\n size is large but stable. The mediastinal contours are within normal limits. \n There continue to be bibasilar and perihilar opacities as well as a more\n rounded confluent opacity in the right upper lung. These findings likely\n represent increased pulmonary edema as well as right upper and lower lobe\n consolidations. Retrocardiac opacity is also compatible with a left lower\n lobe consolidation. The costophrenic angles are excluded from the study\n limiting assessment for subtle pleural effusion. There is no large\n pneumothorax.\n \n IMPRESSION: \n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n', ' WET READ: ___ ___ ___ 2:09 PM\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n ______________________________________________________________________________\n FINAL REPORT\n INDICATION: Status post AVR, question pneumothorax after chest tube removal.\n \n COMPARISON: Chest radiograph on ___.\n \n FINDINGS: One portable AP view of the chest. The Swan-Ganz catheter through\n a right internal jugular approach ends in the region of the main pulmonary\n artery. The left internal jugular catheter ends in the left brachiocephalic\n vein just before the SVC. Endotracheal tube ends 6 cm from the carina. The\n previously seen moderate-to-severe pulmonary edema has slightly improved. The\n right upper lobe parenchymal opacity is unchanged. Mild cardiomegaly is\n stable. Mediastinal and hilar contours are normal. No pneumothorax.\n \n IMPRESSION:\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n', ' FINAL REPORT\n CHEST RADIOGRAPH \n \n INDICATION: Evaluation for pleural effusions.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous radiograph, the right-sided pleural\n effusion has minimally decreased. On the left, however, the effusion has\n substantially increased and leads to a near total opacification of the left\n hemithorax. Subsequently, severe atelectatic changes are present.\n \n The Swan-Ganz catheter has been removed, the right internal jugular vein\n catheter has also been removed, a nasogastric tube, the endotracheal tube and\n a venous introduction sheath remains in situ.\n', ' FINAL REPORT\n CHEST RADIOGRAPH\n \n INDICATION: Extubation, evaluation for pleural effusion.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous exam, the patient has been extubated\n and the nasogastric tube has been removed. The extent of the pre-existing\n pleural effusions have bilaterally increased. There is moderate-to-extensive\n cardiomegaly with bilateral extensive areas of atelectasis. Mild-to-moderate\n fluid overload. No focal parenchymal opacity suggest pneumonia.\n', ' FINAL REPORT\n CHEST RADIOGRAPH\n \n INDICATION: PICC line placement.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous radiograph, the right venous\n introduction sheath has been removed and a left PICC line has been inserted. \n The course of the line is unremarkable, the tip of the line projects over the\n mid SVC. There is no evidence of complications, notably no pneumothorax.\n \n The pre-existing bilateral parenchymal opacities, mostly caused by pleural\n effusions and subsequent atelectasis, have decreased in extent.\n', ' FINAL REPORT\n INDICATION: Status post AVR, assess for effusion.\n \n TECHNIQUE: PA and Lateral radiographs\n \n COMPARISONS: Multiple priors most recently ___\n \n FINDINGS: Rounded right midlung opacity compatible with previously described\n septic embolus is decreased in size from the prior study. Left midlung rounded\n consolidation is more conspicuous than previously seen. Potential etiologies\n include developing pneumonia, additional septic embolus or collection of\n fissural fluid, though the lateral argues against the latter. \n \n Small left pleural effusion is noted along with left greater than right\n bibasilar atelectasis. Marked enlargement of the cardiac silhouette is\n similar to the study from ___ though notably larger than the immediate\n post-procedure study from ___. Left PICC is in satisfactory position in the\n superior cavoatrial junction. Median sternotomy wires and aortic valve\n replacement are also noted.\n \n IMPRESSION: \n 1. More conspicuous left midlung opacity concerning for developing pneumonia\n or septic embolus. \n 2. Improved small left pleural effusion and left greater than right bibasilar\n atelectasis. \n \n Findings were discussed by telephone with ___, NP, by Dr. ___ on\n ___ at ___.\n', ' FINAL REPORT\n INDICATION: Status post AVR, assess left lung opacity.\n \n TECHNIQUE: PA and lateral radiographs of the chest.\n \n COMPARISON: Chest radiograph from ___.\n \n FINDINGS: Rounded bilateral mid lung opacities are again seen, grossly\n unchanged and likely reflect consolidative infectious process given history of\n septic emboli. There is unchanged bibasilar opacification, which is likely\n atelectasis with left greater than right effusions. Cardiac silhouette is\n markedly enlarged, similar to the most recent prior. Left PICC terminates in\n the cavoatrial junction. Median sternotomy wires are intact.\n \n IMPRESSION:\n 1. Unchanged bilateral mid lung opacities likely reflect infectious process\n given history of septic emboli.\n 2. Unchanged or slightly increased left greater than right pleural effusion\n and associated atelectasis.\n']

___M with largyneal cancer, inc WOB // PNA

FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old man with laryngeal cancer and acute respiratory failure in context of opiod use // ET tube position confirmation ET tube position confirmation IMPRESSION: Comparison to ___, 18:21. The position of the right PICC line and of the endotracheal tube are stable and correct. The tip of the endotracheal tube projects approximately 5 cm above the carina. Increasing areas of right basal and left retrocardiac atelectasis. Otherwise unchanged radiographic appearance of the lung and of the heart.

mimic-cxr-jpg_2.0.0_files_p11_p11022245_s57732352_7c113cab-8f9bee61-2b8ef272-d3fb769c-21b9dd1c.jpg

[(4, 197, 4, 27), (4, 195, 23, 58), (4, 194, 18, 32), (4, 194, 0, 33), (4, 191, 18, 59), (4, 189, 14, 20), (4, 188, 20, 11), (4, 188, 16, 21), (4, 186, 18, 52), (4, 184, 13, 27), (0, 0, 10, 18), (0, 0, 9, 40)]

[' FINAL REPORT\n CLINICAL INFORMATION: ___-year-old male with CHF versus pneumonia, intubated.\n \n COMPARISON: None.\n \n FINDINGS: Portable frontal chest radiographs demonstrate intubated patient,\n the tip of the endotracheal tube is positioned 4.1 cm from the level of the\n carina. An orogastric tube is in place and is coiled within the fundus of the\n stomach. There is airspace opacification of the right lung with relative\n sparing of the apex, as well as basilar left lung opacity. Linear atelectasis\n is seen in the right mid lung. The left lung is relatively clear. A focal\n nodular opacity is seen in the left upper lung measuring 8 mm. There is\n linear atelectasis in the left lower lung. There is no definite effusion. \n There is no pneumothorax. \n \n The heart size is enlarged, the mediastinal contours appear grossly\n unremarkable on this portable film.\n \n IMPRESSION:\n 1. Bilateral airspace opacity consistent with lobar pneumonia.\n \n 2. Nodular opacity in the left lung apex, recommend attention on followup.\n \n 3. Moderate cardiomegaly.\n', ' FINAL REPORT\n SINGLE FRONTAL VIEW OF THE CHEST\n \n REASON FOR EXAM: Pneumonia, bacteremia, intubated patient.\n \n Comparison is made to prior study performed a day earlier.\n \n Lines and tubes are in unchanged standard position. Multifocal\n consolidations in the right upper and lower lobes bilaterally left greater\n than right are unchanged. Severe cardiomegaly is stable. There are no new\n lung abnormalities. Probably small right pleural effusion is unchanged.\n', ' FINAL REPORT\n REASON FOR EXAMINATION: Evaluation of the patient with endocarditis,\n intubated.\n \n AP radiograph of the chest was reviewed in comparison to ___.\n \n The ET tube tip is 5 cm above the carina. The right internal jugular line tip\n is at the level of mid SVC. Cardiomegaly is unchanged, moderate to severe. \n The patient continues to be in mild pulmonary edema. Right upper lobe opacity\n appears to be unchanged, representing right upper lobe consolidation, better\n appreciated on the chest CT obtained on ___. Left basal consolidation\n is better appreciated on CT and obscured by the cardiomegaly and pleural\n effusion on the current radiograph.\n', ' PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:38 AM\n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n ______________________________________________________________________________\n FINAL REPORT\n HISTORY: ___-year-old male with endocarditis and intubated.\n \n STUDY: Portable AP semi-upright chest radiograph.\n \n COMPARISON: ___.\n \n FINDINGS: The endotracheal tube tip sits 5 cm above the carina. A left-sided\n IJ central venous catheter tip sits in the left brachiocephalic vein. The\n right-sided IJ central venous catheter tip sits in the upper SVC. The heart\n size is large but stable. The mediastinal contours are within normal limits. \n There continue to be bibasilar and perihilar opacities as well as a more\n rounded confluent opacity in the right upper lung. These findings likely\n represent increased pulmonary edema as well as right upper and lower lobe\n consolidations. Retrocardiac opacity is also compatible with a left lower\n lobe consolidation. The costophrenic angles are excluded from the study\n limiting assessment for subtle pleural effusion. There is no large\n pneumothorax.\n \n IMPRESSION: \n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n', ' WET READ: ___ ___ ___ 2:09 PM\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n ______________________________________________________________________________\n FINAL REPORT\n INDICATION: Status post AVR, question pneumothorax after chest tube removal.\n \n COMPARISON: Chest radiograph on ___.\n \n FINDINGS: One portable AP view of the chest. The Swan-Ganz catheter through\n a right internal jugular approach ends in the region of the main pulmonary\n artery. The left internal jugular catheter ends in the left brachiocephalic\n vein just before the SVC. Endotracheal tube ends 6 cm from the carina. The\n previously seen moderate-to-severe pulmonary edema has slightly improved. The\n right upper lobe parenchymal opacity is unchanged. Mild cardiomegaly is\n stable. Mediastinal and hilar contours are normal. No pneumothorax.\n \n IMPRESSION:\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n', ' FINAL REPORT\n CHEST RADIOGRAPH \n \n INDICATION: Evaluation for pleural effusions.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous radiograph, the right-sided pleural\n effusion has minimally decreased. On the left, however, the effusion has\n substantially increased and leads to a near total opacification of the left\n hemithorax. Subsequently, severe atelectatic changes are present.\n \n The Swan-Ganz catheter has been removed, the right internal jugular vein\n catheter has also been removed, a nasogastric tube, the endotracheal tube and\n a venous introduction sheath remains in situ.\n', ' FINAL REPORT\n CHEST RADIOGRAPH\n \n INDICATION: Extubation, evaluation for pleural effusion.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous exam, the patient has been extubated\n and the nasogastric tube has been removed. The extent of the pre-existing\n pleural effusions have bilaterally increased. There is moderate-to-extensive\n cardiomegaly with bilateral extensive areas of atelectasis. Mild-to-moderate\n fluid overload. No focal parenchymal opacity suggest pneumonia.\n', ' FINAL REPORT\n CHEST RADIOGRAPH\n \n INDICATION: PICC line placement.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous radiograph, the right venous\n introduction sheath has been removed and a left PICC line has been inserted. \n The course of the line is unremarkable, the tip of the line projects over the\n mid SVC. There is no evidence of complications, notably no pneumothorax.\n \n The pre-existing bilateral parenchymal opacities, mostly caused by pleural\n effusions and subsequent atelectasis, have decreased in extent.\n', ' FINAL REPORT\n INDICATION: Status post AVR, assess for effusion.\n \n TECHNIQUE: PA and Lateral radiographs\n \n COMPARISONS: Multiple priors most recently ___\n \n FINDINGS: Rounded right midlung opacity compatible with previously described\n septic embolus is decreased in size from the prior study. Left midlung rounded\n consolidation is more conspicuous than previously seen. Potential etiologies\n include developing pneumonia, additional septic embolus or collection of\n fissural fluid, though the lateral argues against the latter. \n \n Small left pleural effusion is noted along with left greater than right\n bibasilar atelectasis. Marked enlargement of the cardiac silhouette is\n similar to the study from ___ though notably larger than the immediate\n post-procedure study from ___. Left PICC is in satisfactory position in the\n superior cavoatrial junction. Median sternotomy wires and aortic valve\n replacement are also noted.\n \n IMPRESSION: \n 1. More conspicuous left midlung opacity concerning for developing pneumonia\n or septic embolus. \n 2. Improved small left pleural effusion and left greater than right bibasilar\n atelectasis. \n \n Findings were discussed by telephone with ___, NP, by Dr. ___ on\n ___ at ___.\n', ' FINAL REPORT\n INDICATION: Status post AVR, assess left lung opacity.\n \n TECHNIQUE: PA and lateral radiographs of the chest.\n \n COMPARISON: Chest radiograph from ___.\n \n FINDINGS: Rounded bilateral mid lung opacities are again seen, grossly\n unchanged and likely reflect consolidative infectious process given history of\n septic emboli. There is unchanged bibasilar opacification, which is likely\n atelectasis with left greater than right effusions. Cardiac silhouette is\n markedly enlarged, similar to the most recent prior. Left PICC terminates in\n the cavoatrial junction. Median sternotomy wires are intact.\n \n IMPRESSION:\n 1. Unchanged bilateral mid lung opacities likely reflect infectious process\n given history of septic emboli.\n 2. Unchanged or slightly increased left greater than right pleural effusion\n and associated atelectasis.\n', ' FINAL REPORT\n EXAMINATION: CHEST (PORTABLE AP)\n \n INDICATION: ___M with largyneal cancer, inc WOB // PNA\n \n COMPARISON: Prior exam from earlier today.\n \n FINDINGS: \n \n AP portable semi upright view of the chest.\n \n Lung volumes are low limiting assessment. There is increased bibasilar\n atelectasis and bronchovascular crowding. Overall cardiomediastinal\n silhouette is unchanged. The right upper extremity access PICC line appears\n in unchanged position extending to the level of the cavoatrial junction. Mild\n congestion is difficult to exclude in the correct clinical setting. No overt\n signs of edema.\n \n IMPRESSION: \n \n Increasing bibasilar atelectasis. Possible mild pulmonary vascular\n congestion.\n', ' FINAL REPORT\n EXAMINATION: CHEST (PORTABLE AP)\n \n INDICATION: History: ___M with ett tube, pls eval placement //\n \n COMPARISON: Prior exam performed earlier today.\n \n FINDINGS: \n \n AP portable upright view of the chest. There has been interval intubation\n with the tip of the endotracheal tube positioned 3.3 cm above the carina. The\n right upper extremity access PICC line is unchanged. There is increasing\n bibasilar atelectasis.\n \n IMPRESSION: \n \n As above.\n']

___ year old man with laryngeal cancer and acute respiratory failure in context of opiod use // ET tube position confirmation

FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: History: ___M with ett tube, pls eval placement // COMPARISON: Prior exam performed earlier today. FINDINGS: AP portable upright view of the chest. There has been interval intubation with the tip of the endotracheal tube positioned 3.3 cm above the carina. The right upper extremity access PICC line is unchanged. There is increasing bibasilar atelectasis. IMPRESSION: As above.

mimic-cxr-jpg_2.0.0_files_p11_p11022245_s55490259_9ca1e240-842fe6d2-5b26c6f5-a9523752-6603498e.jpg

[(4, 196, 18, 47), (4, 195, 14, 18), (4, 194, 8, 52), (4, 193, 14, 53), (4, 191, 9, 19), (4, 189, 4, 40), (4, 188, 10, 31), (4, 188, 6, 41), (4, 186, 9, 12), (4, 184, 3, 47), (0, 0, 0, 38)]

[' FINAL REPORT\n CLINICAL INFORMATION: ___-year-old male with CHF versus pneumonia, intubated.\n \n COMPARISON: None.\n \n FINDINGS: Portable frontal chest radiographs demonstrate intubated patient,\n the tip of the endotracheal tube is positioned 4.1 cm from the level of the\n carina. An orogastric tube is in place and is coiled within the fundus of the\n stomach. There is airspace opacification of the right lung with relative\n sparing of the apex, as well as basilar left lung opacity. Linear atelectasis\n is seen in the right mid lung. The left lung is relatively clear. A focal\n nodular opacity is seen in the left upper lung measuring 8 mm. There is\n linear atelectasis in the left lower lung. There is no definite effusion. \n There is no pneumothorax. \n \n The heart size is enlarged, the mediastinal contours appear grossly\n unremarkable on this portable film.\n \n IMPRESSION:\n 1. Bilateral airspace opacity consistent with lobar pneumonia.\n \n 2. Nodular opacity in the left lung apex, recommend attention on followup.\n \n 3. Moderate cardiomegaly.\n', ' FINAL REPORT\n SINGLE FRONTAL VIEW OF THE CHEST\n \n REASON FOR EXAM: Pneumonia, bacteremia, intubated patient.\n \n Comparison is made to prior study performed a day earlier.\n \n Lines and tubes are in unchanged standard position. Multifocal\n consolidations in the right upper and lower lobes bilaterally left greater\n than right are unchanged. Severe cardiomegaly is stable. There are no new\n lung abnormalities. Probably small right pleural effusion is unchanged.\n', ' FINAL REPORT\n REASON FOR EXAMINATION: Evaluation of the patient with endocarditis,\n intubated.\n \n AP radiograph of the chest was reviewed in comparison to ___.\n \n The ET tube tip is 5 cm above the carina. The right internal jugular line tip\n is at the level of mid SVC. Cardiomegaly is unchanged, moderate to severe. \n The patient continues to be in mild pulmonary edema. Right upper lobe opacity\n appears to be unchanged, representing right upper lobe consolidation, better\n appreciated on the chest CT obtained on ___. Left basal consolidation\n is better appreciated on CT and obscured by the cardiomegaly and pleural\n effusion on the current radiograph.\n', ' PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:38 AM\n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n ______________________________________________________________________________\n FINAL REPORT\n HISTORY: ___-year-old male with endocarditis and intubated.\n \n STUDY: Portable AP semi-upright chest radiograph.\n \n COMPARISON: ___.\n \n FINDINGS: The endotracheal tube tip sits 5 cm above the carina. A left-sided\n IJ central venous catheter tip sits in the left brachiocephalic vein. The\n right-sided IJ central venous catheter tip sits in the upper SVC. The heart\n size is large but stable. The mediastinal contours are within normal limits. \n There continue to be bibasilar and perihilar opacities as well as a more\n rounded confluent opacity in the right upper lung. These findings likely\n represent increased pulmonary edema as well as right upper and lower lobe\n consolidations. Retrocardiac opacity is also compatible with a left lower\n lobe consolidation. The costophrenic angles are excluded from the study\n limiting assessment for subtle pleural effusion. There is no large\n pneumothorax.\n \n IMPRESSION: \n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n', ' WET READ: ___ ___ ___ 2:09 PM\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n ______________________________________________________________________________\n FINAL REPORT\n INDICATION: Status post AVR, question pneumothorax after chest tube removal.\n \n COMPARISON: Chest radiograph on ___.\n \n FINDINGS: One portable AP view of the chest. The Swan-Ganz catheter through\n a right internal jugular approach ends in the region of the main pulmonary\n artery. The left internal jugular catheter ends in the left brachiocephalic\n vein just before the SVC. Endotracheal tube ends 6 cm from the carina. The\n previously seen moderate-to-severe pulmonary edema has slightly improved. The\n right upper lobe parenchymal opacity is unchanged. Mild cardiomegaly is\n stable. Mediastinal and hilar contours are normal. No pneumothorax.\n \n IMPRESSION:\n 1. Slightly decreased pulmonary edema compared to most recent study, however\n right upper and lower lobe parenchymal opacities are more prominent and may\n represent pneumonia. \n \n 2. Lines and tubes are in standard position.\n', ' FINAL REPORT\n CHEST RADIOGRAPH \n \n INDICATION: Evaluation for pleural effusions.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous radiograph, the right-sided pleural\n effusion has minimally decreased. On the left, however, the effusion has\n substantially increased and leads to a near total opacification of the left\n hemithorax. Subsequently, severe atelectatic changes are present.\n \n The Swan-Ganz catheter has been removed, the right internal jugular vein\n catheter has also been removed, a nasogastric tube, the endotracheal tube and\n a venous introduction sheath remains in situ.\n', ' FINAL REPORT\n CHEST RADIOGRAPH\n \n INDICATION: Extubation, evaluation for pleural effusion.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous exam, the patient has been extubated\n and the nasogastric tube has been removed. The extent of the pre-existing\n pleural effusions have bilaterally increased. There is moderate-to-extensive\n cardiomegaly with bilateral extensive areas of atelectasis. Mild-to-moderate\n fluid overload. No focal parenchymal opacity suggest pneumonia.\n', ' FINAL REPORT\n CHEST RADIOGRAPH\n \n INDICATION: PICC line placement.\n \n COMPARISON: ___.\n \n FINDINGS: As compared to the previous radiograph, the right venous\n introduction sheath has been removed and a left PICC line has been inserted. \n The course of the line is unremarkable, the tip of the line projects over the\n mid SVC. There is no evidence of complications, notably no pneumothorax.\n \n The pre-existing bilateral parenchymal opacities, mostly caused by pleural\n effusions and subsequent atelectasis, have decreased in extent.\n', ' FINAL REPORT\n INDICATION: Status post AVR, assess for effusion.\n \n TECHNIQUE: PA and Lateral radiographs\n \n COMPARISONS: Multiple priors most recently ___\n \n FINDINGS: Rounded right midlung opacity compatible with previously described\n septic embolus is decreased in size from the prior study. Left midlung rounded\n consolidation is more conspicuous than previously seen. Potential etiologies\n include developing pneumonia, additional septic embolus or collection of\n fissural fluid, though the lateral argues against the latter. \n \n Small left pleural effusion is noted along with left greater than right\n bibasilar atelectasis. Marked enlargement of the cardiac silhouette is\n similar to the study from ___ though notably larger than the immediate\n post-procedure study from ___. Left PICC is in satisfactory position in the\n superior cavoatrial junction. Median sternotomy wires and aortic valve\n replacement are also noted.\n \n IMPRESSION: \n 1. More conspicuous left midlung opacity concerning for developing pneumonia\n or septic embolus. \n 2. Improved small left pleural effusion and left greater than right bibasilar\n atelectasis. \n \n Findings were discussed by telephone with ___, NP, by Dr. ___ on\n ___ at ___.\n', ' FINAL REPORT\n INDICATION: Status post AVR, assess left lung opacity.\n \n TECHNIQUE: PA and lateral radiographs of the chest.\n \n COMPARISON: Chest radiograph from ___.\n \n FINDINGS: Rounded bilateral mid lung opacities are again seen, grossly\n unchanged and likely reflect consolidative infectious process given history of\n septic emboli. There is unchanged bibasilar opacification, which is likely\n atelectasis with left greater than right effusions. Cardiac silhouette is\n markedly enlarged, similar to the most recent prior. Left PICC terminates in\n the cavoatrial junction. Median sternotomy wires are intact.\n \n IMPRESSION:\n 1. Unchanged bilateral mid lung opacities likely reflect infectious process\n given history of septic emboli.\n 2. Unchanged or slightly increased left greater than right pleural effusion\n and associated atelectasis.\n', ' FINAL REPORT\n EXAMINATION: CHEST (PORTABLE AP)\n \n INDICATION: ___M with largyneal cancer, inc WOB // PNA\n \n COMPARISON: Prior exam from earlier today.\n \n FINDINGS: \n \n AP portable semi upright view of the chest.\n \n Lung volumes are low limiting assessment. There is increased bibasilar\n atelectasis and bronchovascular crowding. Overall cardiomediastinal\n silhouette is unchanged. The right upper extremity access PICC line appears\n in unchanged position extending to the level of the cavoatrial junction. Mild\n congestion is difficult to exclude in the correct clinical setting. No overt\n signs of edema.\n \n IMPRESSION: \n \n Increasing bibasilar atelectasis. Possible mild pulmonary vascular\n congestion.\n']

History: ___M with ett tube, pls eval placement

FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with endocarditis, intubated. AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is 5 cm above the carina. The right internal jugular line tip is at the level of mid SVC. Cardiomegaly is unchanged, moderate to severe. The patient continues to be in mild pulmonary edema. Right upper lobe opacity appears to be unchanged, representing right upper lobe consolidation, better appreciated on the chest CT obtained on ___. Left basal consolidation is better appreciated on CT and obscured by the cardiomegaly and pleural effusion on the current radiograph.

mimic-cxr-jpg_2.0.0_files_p11_p11022245_s56303122_4b060466-eed839b9-97b85751-c9cb7084-852b9f42.jpg

[(0, 2, 9, 55), (0, 1, 5, 26)]

[' FINAL REPORT\n CLINICAL INFORMATION: ___-year-old male with CHF versus pneumonia, intubated.\n \n COMPARISON: None.\n \n FINDINGS: Portable frontal chest radiographs demonstrate intubated patient,\n the tip of the endotracheal tube is positioned 4.1 cm from the level of the\n carina. An orogastric tube is in place and is coiled within the fundus of the\n stomach. There is airspace opacification of the right lung with relative\n sparing of the apex, as well as basilar left lung opacity. Linear atelectasis\n is seen in the right mid lung. The left lung is relatively clear. A focal\n nodular opacity is seen in the left upper lung measuring 8 mm. There is\n linear atelectasis in the left lower lung. There is no definite effusion. \n There is no pneumothorax. \n \n The heart size is enlarged, the mediastinal contours appear grossly\n unremarkable on this portable film.\n \n IMPRESSION:\n 1. Bilateral airspace opacity consistent with lobar pneumonia.\n \n 2. Nodular opacity in the left lung apex, recommend attention on followup.\n \n 3. Moderate cardiomegaly.\n', ' FINAL REPORT\n SINGLE FRONTAL VIEW OF THE CHEST\n \n REASON FOR EXAM: Pneumonia, bacteremia, intubated patient.\n \n Comparison is made to prior study performed a day earlier.\n \n Lines and tubes are in unchanged standard position. Multifocal\n consolidations in the right upper and lower lobes bilaterally left greater\n than right are unchanged. Severe cardiomegaly is stable. There are no new\n lung abnormalities. Probably small right pleural effusion is unchanged.\n']

Evaluation of the patient with endocarditis, intubated.

FINAL REPORT REASON FOR EXAMINATION: Evaluation of the patient with endocarditis, intubated. AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is 5 cm above the carina. The right internal jugular line tip is at the level of mid SVC. Cardiomegaly is unchanged, moderate to severe. The patient continues to be in mild pulmonary edema. Right upper lobe opacity appears to be unchanged, representing right upper lobe consolidation, better appreciated on the chest CT obtained on ___. Left basal consolidation is better appreciated on CT and obscured by the cardiomegaly and pleural effusion on the current radiograph.

mimic-cxr-jpg_2.0.0_files_p11_p11022245_s56303122_afed4c34-cf95e16b-371ce2be-99427d54-2013960b.jpg

[(0, 2, 9, 55), (0, 1, 5, 26)]

[' FINAL REPORT\n CLINICAL INFORMATION: ___-year-old male with CHF versus pneumonia, intubated.\n \n COMPARISON: None.\n \n FINDINGS: Portable frontal chest radiographs demonstrate intubated patient,\n the tip of the endotracheal tube is positioned 4.1 cm from the level of the\n carina. An orogastric tube is in place and is coiled within the fundus of the\n stomach. There is airspace opacification of the right lung with relative\n sparing of the apex, as well as basilar left lung opacity. Linear atelectasis\n is seen in the right mid lung. The left lung is relatively clear. A focal\n nodular opacity is seen in the left upper lung measuring 8 mm. There is\n linear atelectasis in the left lower lung. There is no definite effusion. \n There is no pneumothorax. \n \n The heart size is enlarged, the mediastinal contours appear grossly\n unremarkable on this portable film.\n \n IMPRESSION:\n 1. Bilateral airspace opacity consistent with lobar pneumonia.\n \n 2. Nodular opacity in the left lung apex, recommend attention on followup.\n \n 3. Moderate cardiomegaly.\n', ' FINAL REPORT\n SINGLE FRONTAL VIEW OF THE CHEST\n \n REASON FOR EXAM: Pneumonia, bacteremia, intubated patient.\n \n Comparison is made to prior study performed a day earlier.\n \n Lines and tubes are in unchanged standard position. Multifocal\n consolidations in the right upper and lower lobes bilaterally left greater\n than right are unchanged. Severe cardiomegaly is stable. There are no new\n lung abnormalities. Probably small right pleural effusion is unchanged.\n']

Evaluation of the patient with endocarditis, intubated.

WET READ: ___ ___ ___ 2:09 PM 1. Slightly decreased pulmonary edema compared to most recent study, however right upper and lower lobe parenchymal opacities are more prominent and may represent pneumonia. 2. Lines and tubes are in standard position. ______________________________________________________________________________ FINAL REPORT INDICATION: Status post AVR, question pneumothorax after chest tube removal. COMPARISON: Chest radiograph on ___. FINDINGS: One portable AP view of the chest. The Swan-Ganz catheter through a right internal jugular approach ends in the region of the main pulmonary artery. The left internal jugular catheter ends in the left brachiocephalic vein just before the SVC. Endotracheal tube ends 6 cm from the carina. The previously seen moderate-to-severe pulmonary edema has slightly improved. The right upper lobe parenchymal opacity is unchanged. Mild cardiomegaly is stable. Mediastinal and hilar contours are normal. No pneumothorax. IMPRESSION: 1. Slightly decreased pulmonary edema compared to most recent study, however right upper and lower lobe parenchymal opacities are more prominent and may represent pneumonia. 2. Lines and tubes are in standard position.

mimic-cxr-jpg_2.0.0_files_p11_p11022245_s51656138_24754e52-7336ea34-603896e1-a86b2dd6-17909981.jpg

[(0, 5, 9, 28), (0, 4, 4, 59), (0, 2, 23, 33), (0, 2, 5, 34)]

[' FINAL REPORT\n CLINICAL INFORMATION: ___-year-old male with CHF versus pneumonia, intubated.\n \n COMPARISON: None.\n \n FINDINGS: Portable frontal chest radiographs demonstrate intubated patient,\n the tip of the endotracheal tube is positioned 4.1 cm from the level of the\n carina. An orogastric tube is in place and is coiled within the fundus of the\n stomach. There is airspace opacification of the right lung with relative\n sparing of the apex, as well as basilar left lung opacity. Linear atelectasis\n is seen in the right mid lung. The left lung is relatively clear. A focal\n nodular opacity is seen in the left upper lung measuring 8 mm. There is\n linear atelectasis in the left lower lung. There is no definite effusion. \n There is no pneumothorax. \n \n The heart size is enlarged, the mediastinal contours appear grossly\n unremarkable on this portable film.\n \n IMPRESSION:\n 1. Bilateral airspace opacity consistent with lobar pneumonia.\n \n 2. Nodular opacity in the left lung apex, recommend attention on followup.\n \n 3. Moderate cardiomegaly.\n', ' FINAL REPORT\n SINGLE FRONTAL VIEW OF THE CHEST\n \n REASON FOR EXAM: Pneumonia, bacteremia, intubated patient.\n \n Comparison is made to prior study performed a day earlier.\n \n Lines and tubes are in unchanged standard position. Multifocal\n consolidations in the right upper and lower lobes bilaterally left greater\n than right are unchanged. Severe cardiomegaly is stable. There are no new\n lung abnormalities. Probably small right pleural effusion is unchanged.\n', ' FINAL REPORT\n REASON FOR EXAMINATION: Evaluation of the patient with endocarditis,\n intubated.\n \n AP radiograph of the chest was reviewed in comparison to ___.\n \n The ET tube tip is 5 cm above the carina. The right internal jugular line tip\n is at the level of mid SVC. Cardiomegaly is unchanged, moderate to severe. \n The patient continues to be in mild pulmonary edema. Right upper lobe opacity\n appears to be unchanged, representing right upper lobe consolidation, better\n appreciated on the chest CT obtained on ___. Left basal consolidation\n is better appreciated on CT and obscured by the cardiomegaly and pleural\n effusion on the current radiograph.\n', ' PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:38 AM\n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n ______________________________________________________________________________\n FINAL REPORT\n HISTORY: ___-year-old male with endocarditis and intubated.\n \n STUDY: Portable AP semi-upright chest radiograph.\n \n COMPARISON: ___.\n \n FINDINGS: The endotracheal tube tip sits 5 cm above the carina. A left-sided\n IJ central venous catheter tip sits in the left brachiocephalic vein. The\n right-sided IJ central venous catheter tip sits in the upper SVC. The heart\n size is large but stable. The mediastinal contours are within normal limits. \n There continue to be bibasilar and perihilar opacities as well as a more\n rounded confluent opacity in the right upper lung. These findings likely\n represent increased pulmonary edema as well as right upper and lower lobe\n consolidations. Retrocardiac opacity is also compatible with a left lower\n lobe consolidation. The costophrenic angles are excluded from the study\n limiting assessment for subtle pleural effusion. There is no large\n pneumothorax.\n \n IMPRESSION: \n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n']

Status post AVR, question pneumothorax after chest tube removal

WET READ: ___ ___ ___ 2:09 PM 1. Slightly decreased pulmonary edema compared to most recent study, however right upper and lower lobe parenchymal opacities are more prominent and may represent pneumonia. 2. Lines and tubes are in standard position. ______________________________________________________________________________ FINAL REPORT INDICATION: Status post AVR, question pneumothorax after chest tube removal. COMPARISON: Chest radiograph on ___. FINDINGS: One portable AP view of the chest. The Swan-Ganz catheter through a right internal jugular approach ends in the region of the main pulmonary artery. The left internal jugular catheter ends in the left brachiocephalic vein just before the SVC. Endotracheal tube ends 6 cm from the carina. The previously seen moderate-to-severe pulmonary edema has slightly improved. The right upper lobe parenchymal opacity is unchanged. Mild cardiomegaly is stable. Mediastinal and hilar contours are normal. No pneumothorax. IMPRESSION: 1. Slightly decreased pulmonary edema compared to most recent study, however right upper and lower lobe parenchymal opacities are more prominent and may represent pneumonia. 2. Lines and tubes are in standard position.

mimic-cxr-jpg_2.0.0_files_p11_p11022245_s51656138_64988a4a-7c2cfce5-4e93b5ca-d55602d6-94c83006.jpg

[(0, 5, 9, 28), (0, 4, 4, 59), (0, 2, 23, 33), (0, 2, 5, 34)]

[' FINAL REPORT\n CLINICAL INFORMATION: ___-year-old male with CHF versus pneumonia, intubated.\n \n COMPARISON: None.\n \n FINDINGS: Portable frontal chest radiographs demonstrate intubated patient,\n the tip of the endotracheal tube is positioned 4.1 cm from the level of the\n carina. An orogastric tube is in place and is coiled within the fundus of the\n stomach. There is airspace opacification of the right lung with relative\n sparing of the apex, as well as basilar left lung opacity. Linear atelectasis\n is seen in the right mid lung. The left lung is relatively clear. A focal\n nodular opacity is seen in the left upper lung measuring 8 mm. There is\n linear atelectasis in the left lower lung. There is no definite effusion. \n There is no pneumothorax. \n \n The heart size is enlarged, the mediastinal contours appear grossly\n unremarkable on this portable film.\n \n IMPRESSION:\n 1. Bilateral airspace opacity consistent with lobar pneumonia.\n \n 2. Nodular opacity in the left lung apex, recommend attention on followup.\n \n 3. Moderate cardiomegaly.\n', ' FINAL REPORT\n SINGLE FRONTAL VIEW OF THE CHEST\n \n REASON FOR EXAM: Pneumonia, bacteremia, intubated patient.\n \n Comparison is made to prior study performed a day earlier.\n \n Lines and tubes are in unchanged standard position. Multifocal\n consolidations in the right upper and lower lobes bilaterally left greater\n than right are unchanged. Severe cardiomegaly is stable. There are no new\n lung abnormalities. Probably small right pleural effusion is unchanged.\n', ' FINAL REPORT\n REASON FOR EXAMINATION: Evaluation of the patient with endocarditis,\n intubated.\n \n AP radiograph of the chest was reviewed in comparison to ___.\n \n The ET tube tip is 5 cm above the carina. The right internal jugular line tip\n is at the level of mid SVC. Cardiomegaly is unchanged, moderate to severe. \n The patient continues to be in mild pulmonary edema. Right upper lobe opacity\n appears to be unchanged, representing right upper lobe consolidation, better\n appreciated on the chest CT obtained on ___. Left basal consolidation\n is better appreciated on CT and obscured by the cardiomegaly and pleural\n effusion on the current radiograph.\n', ' PROVISIONAL FINDINGS IMPRESSION (PFI): ___ ___ ___ 11:38 AM\n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n ______________________________________________________________________________\n FINAL REPORT\n HISTORY: ___-year-old male with endocarditis and intubated.\n \n STUDY: Portable AP semi-upright chest radiograph.\n \n COMPARISON: ___.\n \n FINDINGS: The endotracheal tube tip sits 5 cm above the carina. A left-sided\n IJ central venous catheter tip sits in the left brachiocephalic vein. The\n right-sided IJ central venous catheter tip sits in the upper SVC. The heart\n size is large but stable. The mediastinal contours are within normal limits. \n There continue to be bibasilar and perihilar opacities as well as a more\n rounded confluent opacity in the right upper lung. These findings likely\n represent increased pulmonary edema as well as right upper and lower lobe\n consolidations. Retrocardiac opacity is also compatible with a left lower\n lobe consolidation. The costophrenic angles are excluded from the study\n limiting assessment for subtle pleural effusion. There is no large\n pneumothorax.\n \n IMPRESSION: \n 1. Lines and tubes in place. \n 2. Increased pulmonary edema with right upper lobe and bibasilar\n consolidations.\n']

Status post AVR, question pneumothorax after chest tube removal

FINAL REPORT SINGLE FRONTAL VIEW OF THE CHEST REASON FOR EXAM: Pneumonia, bacteremia, intubated patient. Comparison is made to prior study performed a day earlier. Lines and tubes are in unchanged standard position. Multifocal consolidations in the right upper and lower lobes bilaterally left greater than right are unchanged. Severe cardiomegaly is stable. There are no new lung abnormalities. Probably small right pleural effusion is unchanged.

mimic-cxr-jpg_2.0.0_files_p11_p11022245_s55512076_d5d3964c-238d57c2-52e7bc5c-5233980d-1f0a2e2a.jpg

[(0, 1, 4, 29)]

[' FINAL REPORT\n CLINICAL INFORMATION: ___-year-old male with CHF versus pneumonia, intubated.\n \n COMPARISON: None.\n \n FINDINGS: Portable frontal chest radiographs demonstrate intubated patient,\n the tip of the endotracheal tube is positioned 4.1 cm from the level of the\n carina. An orogastric tube is in place and is coiled within the fundus of the\n stomach. There is airspace opacification of the right lung with relative\n sparing of the apex, as well as basilar left lung opacity. Linear atelectasis\n is seen in the right mid lung. The left lung is relatively clear. A focal\n nodular opacity is seen in the left upper lung measuring 8 mm. There is\n linear atelectasis in the left lower lung. There is no definite effusion. \n There is no pneumothorax. \n \n The heart size is enlarged, the mediastinal contours appear grossly\n unremarkable on this portable film.\n \n IMPRESSION:\n 1. Bilateral airspace opacity consistent with lobar pneumonia.\n \n 2. Nodular opacity in the left lung apex, recommend attention on followup.\n \n 3. Moderate cardiomegaly.\n']

Pneumonia, bacteremia, intubated patient.

FINAL REPORT CLINICAL INFORMATION: ___-year-old male with CHF versus pneumonia, intubated. COMPARISON: None. FINDINGS: Portable frontal chest radiographs demonstrate intubated patient, the tip of the endotracheal tube is positioned 4.1 cm from the level of the carina. An orogastric tube is in place and is coiled within the fundus of the stomach. There is airspace opacification of the right lung with relative sparing of the apex, as well as basilar left lung opacity. Linear atelectasis is seen in the right mid lung. The left lung is relatively clear. A focal nodular opacity is seen in the left upper lung measuring 8 mm. There is linear atelectasis in the left lower lung. There is no definite effusion. There is no pneumothorax. The heart size is enlarged, the mediastinal contours appear grossly unremarkable on this portable film. IMPRESSION: 1. Bilateral airspace opacity consistent with lobar pneumonia. 2. Nodular opacity in the left lung apex, recommend attention on followup. 3. Moderate cardiomegaly.

mimic-cxr-jpg_2.0.0_files_p11_p11022245_s50078440_816f21ae-13fa33ff-7a4ea5d9-e246fa18-f09a32ff.jpg

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___-year-old male with CHF versus pneumonia, intubated.

FINAL REPORT CLINICAL INFORMATION: ___-year-old male with CHF versus pneumonia, intubated. COMPARISON: None. FINDINGS: Portable frontal chest radiographs demonstrate intubated patient, the tip of the endotracheal tube is positioned 4.1 cm from the level of the carina. An orogastric tube is in place and is coiled within the fundus of the stomach. There is airspace opacification of the right lung with relative sparing of the apex, as well as basilar left lung opacity. Linear atelectasis is seen in the right mid lung. The left lung is relatively clear. A focal nodular opacity is seen in the left upper lung measuring 8 mm. There is linear atelectasis in the left lower lung. There is no definite effusion. There is no pneumothorax. The heart size is enlarged, the mediastinal contours appear grossly unremarkable on this portable film. IMPRESSION: 1. Bilateral airspace opacity consistent with lobar pneumonia. 2. Nodular opacity in the left lung apex, recommend attention on followup. 3. Moderate cardiomegaly.

mimic-cxr-jpg_2.0.0_files_p11_p11022245_s50078440_70ee568a-e2a70b5f-9f73d45e-c3015d3a-2a6bf3c0.jpg

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[]

___-year-old male with CHF versus pneumonia, intubated.

FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ y/o woman with hx multiple LGIB, severe diverticulosis, diastolic CHF, DM2 presenting with bloody stools and acute on chronic anemia, now with RVR 150s and new O2 requirement // new O2 requirement new O2 requirement COMPARISON: ___ IMPRESSION: Heart size and mediastinum are stable. No change in mild cardiomegaly and prominence of the main pulmonary arteries present. Mild vascular congestion is present but there is no overt pulmonary edema. No appreciable pleural effusion or pneumothorax.

mimic-cxr-jpg_2.0.0_files_p11_p11052273_s57433211_f0f60c0b-52abfabd-2b92739a-f825fa77-74c719e9.jpg

[(4, 15, 9, 26), (4, 13, 9, 0), (2, 98, 16, 30), (1, 360, 4, 9), (0, 153, 0, 34), (0, 1, 4, 27)]

[' FINAL REPORT\n INDICATION: Dyspnea on exertion.\n \n COMPARISON: ___.\n \n PA AND LATERAL VIEWS OF THE CHEST: Mild cardiomegaly is unchanged compared to\n the prior study. Aortic knob calcifications are again noted. The mediastinal\n and hilar contours are stable. Previously noted pattern of mild pulmonary\n vascular congestion has essentially resolved. Streaky opacity in the right\n lung base likely reflects atelectasis. No pleural effusion, focal\n consolidation or pneumothorax is identified. No acute osseous abnormality is\n seen.\n \n IMPRESSION: No definite evidence for congestive heart failure. Patchy\n streaky opacity in the right lung base likely reflects atelectasis though\n infection is difficult to exclude.\n', ' FINAL REPORT\n PA AND LATERAL CHEST FILM\n \n CLINICAL INDICATION: ___-year-old woman with cough and fever, evaluate for\n acute process.\n \n Comparison is ___.\n \n PA and lateral views dated ___ at 13:25 are submitted.\n \n IMPRESSION:\n \n Overall, cardiac and mediastinal contours are stable. Interval appearance of\n patchy opacity at the left base could represent early pneumonia, although\n aspiration or patchy atelectasis would also be in the differential. Clinical\n correlation is advised. No evidence of pulmonary edema, pneumothorax or\n pleural effusions. No acute bony abnormality.\n', ' FINAL REPORT\n INDICATION: Shortness of breath.\n \n COMPARISON: Chest radiograph on ___.\n \n FINDINGS: AP and lateral views of the chest. \n \n Thereis hyperinflation, consistent with background COPD. There is increased\n diffuse parenchymal opacities bilaterally, more prominent at the bases\n consistent with mild pulmonary edema. There are small bilateral pleural\n effusions layering posteriorly, left greater than right. There is fluid in\n the major fissure seen on the lateral view. There is moderate cardiomegaly. \n No pneumothorax. The left hemidiaphragm is elevated laterally. \n \n IMPRESSION: Moderate cardiomegaly, mild pulmonary edema and small bilateral\n pleural effusions consistent with CHF.\n', ' FINAL REPORT\n PORTABLE CHEST, ___\n \n HISTORY: ___-year-old female with shortness of breath.\n \n COMPARISON: ___.\n \n FINDINGS: Single portable view of the chest. Bibasilar opacities with\n blunting of the costophrenic angles which could be due to effusions. There\n are indistinct pulmonary vascular markings. Relatively lentiform-shaped\n opacity over the right mid lung is suggestive of fluid within the fissure. \n The cardiac silhouette is enlarged, similar to prior. Atherosclerotic\n calcifications are noted.\n \n IMPRESSION: Pulmonary vascular congestion, small effusions with probable\n fluid in the right fissure.\n', ' FINAL REPORT\n EXAMINATION: CHEST (PA AND LAT)\n \n INDICATION: ___F with weakness // ? pna\n \n COMPARISON: ___\n \n FINDINGS: \n \n PA and lateral views of the chest provided. There is no focal consolidation,\n effusion, or pneumothorax. The cardiomediastinal silhouette is stable and\n top-normal in size. Imaged osseous structures are intact. No free air below\n the right hemidiaphragm is seen.\n \n IMPRESSION: \n \n No acute intrathoracic process.\n', ' WET READ: ___ ___ ___ 6:21 PM\n Mild edema. Mild to moderate cardiomegaly. Cardial pulmonary vascular\n congestion. No large pleural effusion. No pneumothorax. Elevation a left\n hemidiaphragm appears chronic similar to ___. No definite focal\n pneumonia.\n ______________________________________________________________________________\n FINAL REPORT\n EXAMINATION: CHEST (PORTABLE AP)\n \n INDICATION: ___ year old woman with recurrent GI bleed, admitted with melena,\n leukocytosis. // ? PNA ? PNA\n \n COMPARISON: Prior chest radiographs since ___ most recently ___.\n \n IMPRESSION: \n \n Moderate cardiomegaly is comparable, but pulmonary vascular congestion and\n upper lobe redistribution of blood flow have developed. There is no pulmonary\n edema or appreciable pleural effusion. No pneumothorax. No focal\n consolidation to suggest pneumonia.\n']

woman with hx multiple LGIB, severe diverticulosis, diastolic CHF, DM2 presenting with bloody stools and acute on chronic anemia, now with RVR 150s and new O2 requirement

WET READ: ___ ___ ___ 6:21 PM Mild edema. Mild to moderate cardiomegaly. Cardial pulmonary vascular congestion. No large pleural effusion. No pneumothorax. Elevation a left hemidiaphragm appears chronic similar to ___. No definite focal pneumonia. ______________________________________________________________________________ FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with recurrent GI bleed, admitted with melena, leukocytosis. // ? PNA ? PNA COMPARISON: Prior chest radiographs since ___ most recently ___. IMPRESSION: Moderate cardiomegaly is comparable, but pulmonary vascular congestion and upper lobe redistribution of blood flow have developed. There is no pulmonary edema or appreciable pleural effusion. No pneumothorax. No focal consolidation to suggest pneumonia.

mimic-cxr-jpg_2.0.0_files_p11_p11052273_s58377417_97cfb5fb-f151949c-ec5357b7-3b5b1046-5ef2a77c.jpg

[(4, 14, 4, 59), (4, 12, 4, 33), (2, 97, 12, 3), (1, 358, 23, 42), (0, 151, 20, 7)]

[' FINAL REPORT\n INDICATION: Dyspnea on exertion.\n \n COMPARISON: ___.\n \n PA AND LATERAL VIEWS OF THE CHEST: Mild cardiomegaly is unchanged compared to\n the prior study. Aortic knob calcifications are again noted. The mediastinal\n and hilar contours are stable. Previously noted pattern of mild pulmonary\n vascular congestion has essentially resolved. Streaky opacity in the right\n lung base likely reflects atelectasis. No pleural effusion, focal\n consolidation or pneumothorax is identified. No acute osseous abnormality is\n seen.\n \n IMPRESSION: No definite evidence for congestive heart failure. Patchy\n streaky opacity in the right lung base likely reflects atelectasis though\n infection is difficult to exclude.\n', ' FINAL REPORT\n PA AND LATERAL CHEST FILM\n \n CLINICAL INDICATION: ___-year-old woman with cough and fever, evaluate for\n acute process.\n \n Comparison is ___.\n \n PA and lateral views dated ___ at 13:25 are submitted.\n \n IMPRESSION:\n \n Overall, cardiac and mediastinal contours are stable. Interval appearance of\n patchy opacity at the left base could represent early pneumonia, although\n aspiration or patchy atelectasis would also be in the differential. Clinical\n correlation is advised. No evidence of pulmonary edema, pneumothorax or\n pleural effusions. No acute bony abnormality.\n', ' FINAL REPORT\n INDICATION: Shortness of breath.\n \n COMPARISON: Chest radiograph on ___.\n \n FINDINGS: AP and lateral views of the chest. \n \n Thereis hyperinflation, consistent with background COPD. There is increased\n diffuse parenchymal opacities bilaterally, more prominent at the bases\n consistent with mild pulmonary edema. There are small bilateral pleural\n effusions layering posteriorly, left greater than right. There is fluid in\n the major fissure seen on the lateral view. There is moderate cardiomegaly. \n No pneumothorax. The left hemidiaphragm is elevated laterally. \n \n IMPRESSION: Moderate cardiomegaly, mild pulmonary edema and small bilateral\n pleural effusions consistent with CHF.\n', ' FINAL REPORT\n PORTABLE CHEST, ___\n \n HISTORY: ___-year-old female with shortness of breath.\n \n COMPARISON: ___.\n \n FINDINGS: Single portable view of the chest. Bibasilar opacities with\n blunting of the costophrenic angles which could be due to effusions. There\n are indistinct pulmonary vascular markings. Relatively lentiform-shaped\n opacity over the right mid lung is suggestive of fluid within the fissure. \n The cardiac silhouette is enlarged, similar to prior. Atherosclerotic\n calcifications are noted.\n \n IMPRESSION: Pulmonary vascular congestion, small effusions with probable\n fluid in the right fissure.\n', ' FINAL REPORT\n EXAMINATION: CHEST (PA AND LAT)\n \n INDICATION: ___F with weakness // ? pna\n \n COMPARISON: ___\n \n FINDINGS: \n \n PA and lateral views of the chest provided. There is no focal consolidation,\n effusion, or pneumothorax. The cardiomediastinal silhouette is stable and\n top-normal in size. Imaged osseous structures are intact. No free air below\n the right hemidiaphragm is seen.\n \n IMPRESSION: \n \n No acute intrathoracic process.\n']

___ year old woman with recurrent GI bleed, admitted with melena, leukocytosis. // ? PNA ? PNA

FINAL REPORT INDICATION: Dyspnea on exertion. COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: Mild cardiomegaly is unchanged compared to the prior study. Aortic knob calcifications are again noted. The mediastinal and hilar contours are stable. Previously noted pattern of mild pulmonary vascular congestion has essentially resolved. Streaky opacity in the right lung base likely reflects atelectasis. No pleural effusion, focal consolidation or pneumothorax is identified. No acute osseous abnormality is seen. IMPRESSION: No definite evidence for congestive heart failure. Patchy streaky opacity in the right lung base likely reflects atelectasis though infection is difficult to exclude.

mimic-cxr-jpg_2.0.0_files_p11_p11052273_s53537165_f9f7d4af-2d90cb81-2541b729-6aab0e3f-06acb455.jpg

[]

[]

Dyspnea on exertion

FINAL REPORT PORTABLE CHEST, ___ HISTORY: ___-year-old female with shortness of breath. COMPARISON: ___. FINDINGS: Single portable view of the chest. Bibasilar opacities with blunting of the costophrenic angles which could be due to effusions. There are indistinct pulmonary vascular markings. Relatively lentiform-shaped opacity over the right mid lung is suggestive of fluid within the fissure. The cardiac silhouette is enlarged, similar to prior. Atherosclerotic calcifications are noted. IMPRESSION: Pulmonary vascular congestion, small effusions with probable fluid in the right fissure.

mimic-cxr-jpg_2.0.0_files_p11_p11052273_s54389393_d7395617-98bb6ef8-6f0187e5-2c3df909-6f3a57c4.jpg

[(2, 20, 5, 17), (2, 18, 4, 51), (0, 103, 12, 21)]

[' FINAL REPORT\n INDICATION: Dyspnea on exertion.\n \n COMPARISON: ___.\n \n PA AND LATERAL VIEWS OF THE CHEST: Mild cardiomegaly is unchanged compared to\n the prior study. Aortic knob calcifications are again noted. The mediastinal\n and hilar contours are stable. Previously noted pattern of mild pulmonary\n vascular congestion has essentially resolved. Streaky opacity in the right\n lung base likely reflects atelectasis. No pleural effusion, focal\n consolidation or pneumothorax is identified. No acute osseous abnormality is\n seen.\n \n IMPRESSION: No definite evidence for congestive heart failure. Patchy\n streaky opacity in the right lung base likely reflects atelectasis though\n infection is difficult to exclude.\n', ' FINAL REPORT\n PA AND LATERAL CHEST FILM\n \n CLINICAL INDICATION: ___-year-old woman with cough and fever, evaluate for\n acute process.\n \n Comparison is ___.\n \n PA and lateral views dated ___ at 13:25 are submitted.\n \n IMPRESSION:\n \n Overall, cardiac and mediastinal contours are stable. Interval appearance of\n patchy opacity at the left base could represent early pneumonia, although\n aspiration or patchy atelectasis would also be in the differential. Clinical\n correlation is advised. No evidence of pulmonary edema, pneumothorax or\n pleural effusions. No acute bony abnormality.\n', ' FINAL REPORT\n INDICATION: Shortness of breath.\n \n COMPARISON: Chest radiograph on ___.\n \n FINDINGS: AP and lateral views of the chest. \n \n Thereis hyperinflation, consistent with background COPD. There is increased\n diffuse parenchymal opacities bilaterally, more prominent at the bases\n consistent with mild pulmonary edema. There are small bilateral pleural\n effusions layering posteriorly, left greater than right. There is fluid in\n the major fissure seen on the lateral view. There is moderate cardiomegaly. \n No pneumothorax. The left hemidiaphragm is elevated laterally. \n \n IMPRESSION: Moderate cardiomegaly, mild pulmonary edema and small bilateral\n pleural effusions consistent with CHF.\n']

shortness of breath

FINAL REPORT INDICATION: Shortness of breath. COMPARISON: Chest radiograph on ___. FINDINGS: AP and lateral views of the chest. Thereis hyperinflation, consistent with background COPD. There is increased diffuse parenchymal opacities bilaterally, more prominent at the bases consistent with mild pulmonary edema. There are small bilateral pleural effusions layering posteriorly, left greater than right. There is fluid in the major fissure seen on the lateral view. There is moderate cardiomegaly. No pneumothorax. The left hemidiaphragm is elevated laterally. IMPRESSION: Moderate cardiomegaly, mild pulmonary edema and small bilateral pleural effusions consistent with CHF.

mimic-cxr-jpg_2.0.0_files_p11_p11052273_s53702175_e35b1970-3dfc9412-ec657374-09990870-561ca892.jpg

[(1, 281, 16, 56), (1, 279, 16, 30)]

[' FINAL REPORT\n INDICATION: Dyspnea on exertion.\n \n COMPARISON: ___.\n \n PA AND LATERAL VIEWS OF THE CHEST: Mild cardiomegaly is unchanged compared to\n the prior study. Aortic knob calcifications are again noted. The mediastinal\n and hilar contours are stable. Previously noted pattern of mild pulmonary\n vascular congestion has essentially resolved. Streaky opacity in the right\n lung base likely reflects atelectasis. No pleural effusion, focal\n consolidation or pneumothorax is identified. No acute osseous abnormality is\n seen.\n \n IMPRESSION: No definite evidence for congestive heart failure. Patchy\n streaky opacity in the right lung base likely reflects atelectasis though\n infection is difficult to exclude.\n', ' FINAL REPORT\n PA AND LATERAL CHEST FILM\n \n CLINICAL INDICATION: ___-year-old woman with cough and fever, evaluate for\n acute process.\n \n Comparison is ___.\n \n PA and lateral views dated ___ at 13:25 are submitted.\n \n IMPRESSION:\n \n Overall, cardiac and mediastinal contours are stable. Interval appearance of\n patchy opacity at the left base could represent early pneumonia, although\n aspiration or patchy atelectasis would also be in the differential. Clinical\n correlation is advised. No evidence of pulmonary edema, pneumothorax or\n pleural effusions. No acute bony abnormality.\n']

Shortness of breath

FINAL REPORT EXAMINATION: CHEST (PA AND LAT) INDICATION: ___F with weakness // ? pna COMPARISON: ___ FINDINGS: PA and lateral views of the chest provided. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is stable and top-normal in size. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen. IMPRESSION: No acute intrathoracic process.

mimic-cxr-jpg_2.0.0_files_p11_p11052273_s59032183_1d1ad085-bc04d368-4062c6ff-8388f25c-c9acb192.jpg

[(3, 227, 8, 52), (3, 225, 8, 26), (1, 310, 15, 56), (1, 207, 3, 35)]

[' FINAL REPORT\n INDICATION: Dyspnea on exertion.\n \n COMPARISON: ___.\n \n PA AND LATERAL VIEWS OF THE CHEST: Mild cardiomegaly is unchanged compared to\n the prior study. Aortic knob calcifications are again noted. The mediastinal\n and hilar contours are stable. Previously noted pattern of mild pulmonary\n vascular congestion has essentially resolved. Streaky opacity in the right\n lung base likely reflects atelectasis. No pleural effusion, focal\n consolidation or pneumothorax is identified. No acute osseous abnormality is\n seen.\n \n IMPRESSION: No definite evidence for congestive heart failure. Patchy\n streaky opacity in the right lung base likely reflects atelectasis though\n infection is difficult to exclude.\n', ' FINAL REPORT\n PA AND LATERAL CHEST FILM\n \n CLINICAL INDICATION: ___-year-old woman with cough and fever, evaluate for\n acute process.\n \n Comparison is ___.\n \n PA and lateral views dated ___ at 13:25 are submitted.\n \n IMPRESSION:\n \n Overall, cardiac and mediastinal contours are stable. Interval appearance of\n patchy opacity at the left base could represent early pneumonia, although\n aspiration or patchy atelectasis would also be in the differential. Clinical\n correlation is advised. No evidence of pulmonary edema, pneumothorax or\n pleural effusions. No acute bony abnormality.\n', ' FINAL REPORT\n INDICATION: Shortness of breath.\n \n COMPARISON: Chest radiograph on ___.\n \n FINDINGS: AP and lateral views of the chest. \n \n Thereis hyperinflation, consistent with background COPD. There is increased\n diffuse parenchymal opacities bilaterally, more prominent at the bases\n consistent with mild pulmonary edema. There are small bilateral pleural\n effusions layering posteriorly, left greater than right. There is fluid in\n the major fissure seen on the lateral view. There is moderate cardiomegaly. \n No pneumothorax. The left hemidiaphragm is elevated laterally. \n \n IMPRESSION: Moderate cardiomegaly, mild pulmonary edema and small bilateral\n pleural effusions consistent with CHF.\n', ' FINAL REPORT\n PORTABLE CHEST, ___\n \n HISTORY: ___-year-old female with shortness of breath.\n \n COMPARISON: ___.\n \n FINDINGS: Single portable view of the chest. Bibasilar opacities with\n blunting of the costophrenic angles which could be due to effusions. There\n are indistinct pulmonary vascular markings. Relatively lentiform-shaped\n opacity over the right mid lung is suggestive of fluid within the fissure. \n The cardiac silhouette is enlarged, similar to prior. Atherosclerotic\n calcifications are noted.\n \n IMPRESSION: Pulmonary vascular congestion, small effusions with probable\n fluid in the right fissure.\n']

F with weakness // ? pna

FINAL REPORT PA AND LATERAL CHEST FILM CLINICAL INDICATION: ___-year-old woman with cough and fever, evaluate for acute process. Comparison is ___. PA and lateral views dated ___ at 13:25 are submitted. IMPRESSION: Overall, cardiac and mediastinal contours are stable. Interval appearance of patchy opacity at the left base could represent early pneumonia, although aspiration or patchy atelectasis would also be in the differential. Clinical correlation is advised. No evidence of pulmonary edema, pneumothorax or pleural effusions. No acute bony abnormality.

mimic-cxr-jpg_2.0.0_files_p11_p11052273_s53407845_e8da4f53-f62c1459-cc4b5add-8a21431c-c2395de1.jpg

[(0, 2, 0, 26)]

[' FINAL REPORT\n INDICATION: Dyspnea on exertion.\n \n COMPARISON: ___.\n \n PA AND LATERAL VIEWS OF THE CHEST: Mild cardiomegaly is unchanged compared to\n the prior study. Aortic knob calcifications are again noted. The mediastinal\n and hilar contours are stable. Previously noted pattern of mild pulmonary\n vascular congestion has essentially resolved. Streaky opacity in the right\n lung base likely reflects atelectasis. No pleural effusion, focal\n consolidation or pneumothorax is identified. No acute osseous abnormality is\n seen.\n \n IMPRESSION: No definite evidence for congestive heart failure. Patchy\n streaky opacity in the right lung base likely reflects atelectasis though\n infection is difficult to exclude.\n']

___-year-old woman with cough and fever, evaluate for acute process.

FINAL REPORT EXAMINATION: CHEST (PORTABLE AP) INDICATION: ___ year old woman with COPD, dCHF, recent GIB and leukocytosis // acute interval change, new infiltrate vs. volume overload IMPRESSION: Compared to ___ radiograph, cardiomegaly and pulmonary vascular congestion are persistent findings. Worsening patchy and linear opacities in the left mid and lower lung are likely due to atelectasis, and although coexisting infection is not fully excluded. No other relevant changes.

mimic-cxr-jpg_2.0.0_files_p11_p11052273_s56107641_1576fdb0-f3f769a3-0cc33e1a-059fcee1-ff10d20d.jpg

[(4, 62, 15, 44), (4, 60, 15, 18), (2, 145, 22, 48), (2, 42, 10, 27), (0, 200, 6, 52), (0, 48, 10, 45), (0, 47, 6, 18), (0, 2, 15, 30)]

[' FINAL REPORT\n INDICATION: Dyspnea on exertion.\n \n COMPARISON: ___.\n \n PA AND LATERAL VIEWS OF THE CHEST: Mild cardiomegaly is unchanged compared to\n the prior study. Aortic knob calcifications are again noted. The mediastinal\n and hilar contours are stable. Previously noted pattern of mild pulmonary\n vascular congestion has essentially resolved. Streaky opacity in the right\n lung base likely reflects atelectasis. No pleural effusion, focal\n consolidation or pneumothorax is identified. No acute osseous abnormality is\n seen.\n \n IMPRESSION: No definite evidence for congestive heart failure. Patchy\n streaky opacity in the right lung base likely reflects atelectasis though\n infection is difficult to exclude.\n', ' FINAL REPORT\n PA AND LATERAL CHEST FILM\n \n CLINICAL INDICATION: ___-year-old woman with cough and fever, evaluate for\n acute process.\n \n Comparison is ___.\n \n PA and lateral views dated ___ at 13:25 are submitted.\n \n IMPRESSION:\n \n Overall, cardiac and mediastinal contours are stable. Interval appearance of\n patchy opacity at the left base could represent early pneumonia, although\n aspiration or patchy atelectasis would also be in the differential. Clinical\n correlation is advised. No evidence of pulmonary edema, pneumothorax or\n pleural effusions. No acute bony abnormality.\n', ' FINAL REPORT\n INDICATION: Shortness of breath.\n \n COMPARISON: Chest radiograph on ___.\n \n FINDINGS: AP and lateral views of the chest. \n \n Thereis hyperinflation, consistent with background COPD. There is increased\n diffuse parenchymal opacities bilaterally, more prominent at the bases\n consistent with mild pulmonary edema. There are small bilateral pleural\n effusions layering posteriorly, left greater than right. There is fluid in\n the major fissure seen on the lateral view. There is moderate cardiomegaly. \n No pneumothorax. The left hemidiaphragm is elevated laterally. \n \n IMPRESSION: Moderate cardiomegaly, mild pulmonary edema and small bilateral\n pleural effusions consistent with CHF.\n', ' FINAL REPORT\n PORTABLE CHEST, ___\n \n HISTORY: ___-year-old female with shortness of breath.\n \n COMPARISON: ___.\n \n FINDINGS: Single portable view of the chest. Bibasilar opacities with\n blunting of the costophrenic angles which could be due to effusions. There\n are indistinct pulmonary vascular markings. Relatively lentiform-shaped\n opacity over the right mid lung is suggestive of fluid within the fissure. \n The cardiac silhouette is enlarged, similar to prior. Atherosclerotic\n calcifications are noted.\n \n IMPRESSION: Pulmonary vascular congestion, small effusions with probable\n fluid in the right fissure.\n', ' FINAL REPORT\n EXAMINATION: CHEST (PA AND LAT)\n \n INDICATION: ___F with weakness // ? pna\n \n COMPARISON: ___\n \n FINDINGS: \n \n PA and lateral views of the chest provided. There is no focal consolidation,\n effusion, or pneumothorax. The cardiomediastinal silhouette is stable and\n top-normal in size. Imaged osseous structures are intact. No free air below\n the right hemidiaphragm is seen.\n \n IMPRESSION: \n \n No acute intrathoracic process.\n', ' WET READ: ___ ___ ___ 6:21 PM\n Mild edema. Mild to moderate cardiomegaly. Cardial pulmonary vascular\n congestion. No large pleural effusion. No pneumothorax. Elevation a left\n hemidiaphragm appears chronic similar to ___. No definite focal\n pneumonia.\n ______________________________________________________________________________\n FINAL REPORT\n EXAMINATION: CHEST (PORTABLE AP)\n \n INDICATION: ___ year old woman with recurrent GI bleed, admitted with melena,\n leukocytosis. // ? PNA ? PNA\n \n COMPARISON: Prior chest radiographs since ___ most recently ___.\n \n IMPRESSION: \n \n Moderate cardiomegaly is comparable, but pulmonary vascular congestion and\n upper lobe redistribution of blood flow have developed. There is no pulmonary\n edema or appreciable pleural effusion. No pneumothorax. No focal\n consolidation to suggest pneumonia.\n', ' FINAL REPORT\n EXAMINATION: CHEST (PORTABLE AP)\n \n INDICATION: ___ y/o woman with hx multiple LGIB, severe diverticulosis,\n diastolic CHF, DM2 presenting with bloody stools and acute on chronic anemia,\n now with RVR 150s and new O2 requirement // new O2 requirement new O2\n requirement\n \n COMPARISON: ___\n \n IMPRESSION: \n \n Heart size and mediastinum are stable. No change in mild cardiomegaly and\n prominence of the main pulmonary arteries present. Mild vascular congestion\n is present but there is no overt pulmonary edema. No appreciable pleural\n effusion or pneumothorax.\n', ' FINAL REPORT\n EXAMINATION: CHEST (PORTABLE AP)\n \n INDICATION: ___ year old woman with h/o of dCHF and COPD // congestion? \n congestion?\n \n IMPRESSION: \n \n In comparison with the study of ___, there is again some\n enlargement of the cardiac silhouette without definite vascular congestion,\n pleural effusion, or acute focal pneumonia.\n']

___ year old woman with COPD, dCHF, recent GIB and leukocytosis // acute interval change, new infiltrate vs. volume overload