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MIMIC-CXR-JPG/2.0.0/files/p10855616/s57539378/4d16f689-42698ab0-c4961952-760d7a20-c0b6029c.jpg
frontal and lateral views of the chest demonstrate a mildly prominent cardiac silhouette likely accentuated by slightly low lung volumes. the descending aorta is unfolded. the lungs are clear with the exception of plate-like left basilar atelectasis versus pericardial fat pad. a small effusion cannot be excluded in the left base. there is no pneumothorax or vascular congestion. thoracolumbar spondylosis is present.
<unk>-year-old male presents with fever, nausea and vomiting. question acute process.
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the cardiac, mediastinal and hilar contours appear stable. there is no pleural effusion or pneumothorax. no focal opacity is demonstrated. mild-to-moderate rightward convex curvature is again centered along the mid thoracic spine. mild degenerative changes are similar along the lower thoracic spine.
shortness of breath.
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pa and lateral views of the chest provided. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
<unk>f with chest pain.
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frontal and lateral chest demonstrates unremarkable cardiomediastinal and hilar contours. lungs are clear. no pleural effusion or pneumothorax identified. no osseous abnormality present.
fever, tachycardia, cough, sputum, evaluate for pneumonia.
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cardiac size is top normal. aside from a calcified granuloma in the left lower lobe, the lungs are clear. there is no pneumothorax or pleural effusion.
<unk> year old woman with severe flank and upper thoracic pain. // rib fractures
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endotracheal tube tip terminates <num> cm from the carina. orogastric tube is within the stomach as is the side port. cardiac and mediastinal contours are unchanged with a large pseudoaneurysm again noted arising from the aortic arch. streaky opacity in the right lower lobe likely reflects atelectasis. the pulmonary vasculature is not engorged. no pneumothorax or pleural effusion is demonstrated. there has been resection of the proximal right humerus including detected.
intubated.
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left subclavian central venous catheter terminates in the lower superior vena cava. a nasogastric tube terminates in the stomach. the lung volumes are low. the cardiac, mediastinal and hilar contours appear stable. minimal opacities at each lung base suggest minor atelectasis. otherwise, the lungs appear clear. high density material in the visualized transverse and splenic flexure portions of the colon suggests a recent prior contrast administration for a radiologic study. small quantity of hyperdense material at the base of the right lung may represent trace prior aspiration of barium.
<unk> <unk> <unk>'s disease with large right frontal mass and midline shift with acute altered mental status. status post craniotomy and resection.
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left picc line ends at the cavoatrial junction. cardiac silhouette is moderately widened by cardiomegaly and/or pericardial effusion. pulmonary vascular congestion is attributable to a combination of left heart dysfunction and overcirculation due to chronic anemia, but there is no pleural effusion or azygos distension to indicate total body volume overload. lungs are clear. only one of the thoracic vertebral bodies show early h shaped configuration due to sickle cell disease and the spleen is not autoinfarcted; is this patient homozygos for sickle cell disease?
<unk>-year-old with sickle cell disease, here with pain crisis and abdominal as well as chest pain. please assess for infiltrate.
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endotracheal tube appears in position with the tip in the mid trachea. an enteric tube traverses the stomach. right-sided central venous catheter appears stable with the tip at the proximal right atrium. again noted is a moderate left pleural effusion with adjacent atelectasis. consolidation is again noted in the right lower lobe and may reflect site of pulmonary infection. additionally, left lung reticular opacities with septal thickening, better delineated on dedicated ct, are slightly improved and may represent edema with possible coexisting infection or hemorrhage. the right upper lung continues to be spared. cardiac and medistinal contours are stable. there is no pneumothorax.
evaluation of patient with respiratory distress.
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the endotracheal tube is approximately <num> cm above the carina. the swan-ganz catheter is in the right pulmonary artery. the left hemidiaphragm is obscured secondary to left lower lung collapse. cardiomegaly is stable. pulmonary vascular congestion has improved. bilateral pleural effusions have improved. there is no pneumothorax.
<unk> year old man who presented with concern for pna, hypoxemic respiratory failure now with heart failure <unk> flail mitral valve leaflet and pa catheter for ongoing cardiac output monitoring. // evaluate for interval change
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pa and lateral views of the chest provided. port-a-cath is unchanged with its tip in the region of the low svc. there is persistent opacity at the left lung base consistent with effusion and atelectasis. no pneumothorax is seen. known left hilar mass is not clearly visualized. the right lung remains clear. overall cardiomediastinal silhouette is stable. bony structures are intact.
<unk>f with sob // hypoxia, rule out pna or ptx
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an endotracheal tube terminates <num> cm above the carina. an enteric tube courses below the diaphragm, the tip is not included in this examination. there is mild distension of the upper stomach. mild cardiomegaly remains unchanged since <unk>. low lung volumes accentuate the bronchovascular structures. increased opacity at the left lung base could be related to a small amount of pleural fluid or could represent a more focal finding, such as early developing pneumonia. there is engorgement of the mediastinal veins. there is no pulmonary edema.
<unk>-year-old man with ethanol cirrhosis, esophageal varices status post tips presenting with hematemesis. study requested for confirmation of og tube.
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linear opacities in the mid lungs are probably scarring and chronic atelectasis due to long-standing, restrictive pleural thickening. there is no pleural effusion or pneumothorax. heart is normal size. widening of the upper mediastinum and enlargement of the left hilus are long-standing due, respectively, to fat deposition and adenopathy, and adenopathy. diagnosis for all of these chronic findings is uncertain.
history: <unk>m with ?tia, neuro requests cxr to eval pna // history: <unk>m with ?tia, neuro requests cxr to eval pna
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the mediastinal contour is widened and unchanged with a unchanged moderate bilateral pleural effusions. the left lower lobe collapse is also unchanged. there is also stable patchy heterogeneous opacification in the right upper lobe. left pleural effusion is stable.
<unk>-year-old with known aortic dissection and worsening shortness of breath.
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ap view of the chest demonstrates low lung volumes, which accentuate bronchovascular markings. there is no pleural effusion, focal consolidation or pneumothorax. hilar and mediastinal silhouettes are unremarkable. heart size is normal. there is no pulmonary edema. partially imaged upper abdomen is unremarkable.
hypotension.
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the cardiomediastinal and hilar contours are normal. there is no pleural effusion or pneumothorax. lungs are well-expanded and clear without focal consolidation concerning for pneumonia. the upper abdomen is unremarkable.
<unk>m with chest pain and fever.
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frontal and lateral radiographs of the chest were acquired. lung volumes are low, causing exaggeration of the heart size and accentuation of the pulmonary vasculature. there is minimal bilateral lower lobe atelectasis. the lungs are otherwise clear. the heart remains moderately enlarged. the vascular pedicle is markedly widened, increased compared to the most recent radiograph from <unk>. there are no pleural effusions. no pneumothorax is seen. loss of height of vertebral bodies along the thoracolumbar spine do not appear substantially changed compared to the prior study from <unk>.
status post fall. assess for acute intrathoracic process.
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cardiac silhouette size is mildly enlarged. mediastinal and hilar contours are within normal limits. there is no pulmonary edema, pleural effusion or pneumothorax identified. minimal patchy atelectasis is noted in the lung bases without focal consolidation. mild hypertrophic changes are seen in the thoracic spine.
history: <unk>m with concern for concussion vs infection, loss of memory
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heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. there is subtle increased opacity involving the lingula, which could be related to infection. no pleural effusion or pneumothorax is seen.
<unk> year old woman with copd and chf with acute fever, chills, productive cough and hypoxia // ? pneumonia
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mild pulmonary vascular congestion with minimal pulmonary interstitial edema is noted. there is no focal consolidation, pleural effusion or pneumothorax. the heart size is top-normal. the aorta is tortuous.
<unk>f with chest pain, evaluate for acute abnormality.
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pa and lateral views of the chest provided. there is a left chest wall aicd with single lead following the expected course to the right ventricle. previously seen retrocardiac opacity has since resolved. no focal consolidation, pneumothorax or pleural effusion. no pulmonary edema. stable mild cardiomegaly. mediastinal contour is normal.
<unk> year old man with history of congestive cough x one week. pmh of chf // r/o infiltrate, chf
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portable supine chest radiograph is obtained. endotracheal tube terminates <num> cm above the carina and should not be advanced any further. nasogastric tube courses into the stomach and out of view. diffuse predominantly perihilar bilateral hazy opacities accompanied by septal thickening are compatible with moderate pulmonary edema. left retrocardiac opacity is likely atelectasis as it improves on the subsequent image. no pleural effusion or pneumothorax is seen. heart size is normal.
new endotracheal tube. assess position.
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there is a left-sided pacemaker with leads unchanged in position. the heart is mildly enlarged. lungs are hyperinflated. faint opacity at the left lung base may reflect a combination of atelectasis and effusion although an early consolidation is not excluded.
cough and fevers.
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compared to the prior study there is no significant interval change.
<unk> year old man with copd rising fevers // pulmonary process leading to respiratory failure?
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the lungs are clear of focal consolidation, effusion, or vascular congestion. the cardiomediastinal silhouette is stable. no acute osseous abnormalities identified.
<unk>f with shortness of breath // evaluate for pneumonia
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subtle airspace opacities are noted at the bilateral lung bases, but more prominently on the right, and may represent a focal pneumonia. there is no evidence of pneumothorax, pleural effusion, or frank pulmonary edema. the cardiomediastinal silhouette is within normal limits.
history: <unk>f with hypoxia // eval for pna
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frontal and lateral chest radiographs demonstrate a likely normal cardiomediastinal silhouette. left base opacity is likely related to a combination of a small to moderate left pleural effusion and associated consolidation. there is no pneumothorax. the visualized upper abdomen is unremarkable.
evaluate for acute cardiopulmonary process, pneumonia versus widened mediastinum, in a patient with severe chest pain radiating from the back.
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heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities. mild degenerative changes are noted in the lower thoracic spine.
history: <unk>m with leg rash consistent with e nodosum //assess for hilar adenopathy
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there is a linear opacity at the left lung base, which is unchanged since <unk>, and represents scarring. the lungs are otherwise clear. heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.
<unk> year old man with recent pneumonia // please assess for resolution for pneumonia
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left-sided port-a-cath terminates in the low svc without evidence of pneumothorax. there are low lung volumes. no focal consolidation is seen. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable. surgical clips overlie the right lower hemi thorax. extensive heterogeneity of the osseous structures is consistent with history of osseous metastatic disease.
history: <unk>f with neutropenia // infiltrate?
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single portable view of the chest was compared to previous exam from <unk>. small area of opacity identified at the right lung base medially. elsewhere the lungs are clear. single-lead pacing device is in stable position. cardiac silhouette is stable. osseous and soft tissue structures are unremarkable.
<unk>-year-old male with chest pain.
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compared to the prior study there is no significant interval change.
<unk> year old man, intubated, previous hypoxia, fever without source // interval change
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since prior, there has been little change to diffuse bilateral pulmonary opacification. right ij, endotracheal tube, and ngt are unchanged in position. there cardiomediastinal and hilar contours are unchanged. there is no pneumothorax or large pleural effusion.
<unk> year old woman with severe ards, evaluate for interval change.
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the heart again appears mildly enlarged. there is a prominent epicardial fat pad and areas of vague low-attenuation pleural thickening along the right lateral chest wall reflecting areas of intrapleural fat. however, there is no convincing indication of any substantial pleural effusion. there is no pneumothorax. there is again an eventration of the anterior right hemidiaphragm. the lungs appear clear. the bones appear demineralized. moderate degenerative changes affect each glenohumeral joint.
chest pain and dyspnea.
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interstitial markings are diffusely prominent bilaterally but no focal consolidation suggestive of pneumonia is seen. fullness in this central pulmonary vasculature is exaggerated because of low lung volumes and no definite vascular congestion or hilar mass is seen. the heart is at the upper limits of normal in size and the aorta is mildly uncoiled. proliferative osteophytes are seen in the mid and lower thoracic spine but no fracture is visible.
history: <unk>f with chest pain // ?pna
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the lungs are hyperinflated without focal opacities. cardiomediastinal and hilar contours are unremarkable. there is no pleural effusion or pneumothorax.
<unk>-year-old male with shortness of breath, wheezing. evaluate for acute cardiopulmonary process.
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heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.
history: <unk>f with chest pain
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the cardiomediastinal and hilar contours are stable. there is no pleural effusion or pneumothorax. the lungs are well expanded without focal consolidation. right apical scarring is again noted with subsequent upward retraction of the right hilum. a right subclavian approach central venous catheter is present with tip terminating in the right atrium. surgical clips at the right axilla are noted. the patient is status post right mastectomy. the upper abdomen is unremarkable.
<unk>f with epigastric/chest pain.
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the lungs are clear. there is no pneumothorax. the heart and mediastinum are magnified by the projection. degenerative osteophytes at the right glenohumeral joint are incidentally noted.
<unk> year old woman with h/o pvd nonhealing ulcer, s/p multiple revascularizations p/f rle angiogram on <unk> // pre-op surg: <unk> (angiogram)
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pa and lateral views of the chest provided. lungs appear clear though volumes are somewhat low. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
<unk>m with cough // acute process?
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the heart is normal in size. mildly prominent upper mediastinal contours appear stable, however, since prior examinations. there is a nodular density projecting over the left lower lung of approximately <num> mm in diameter, suspected to represent a nipple shadow, but a pulmonary nodule cannot be excluded. otherwise the lung fields appear clear. there is no pleural effusion or pneumothorax. mild degenerative changes are similar along the thoracic spine.
hallucinations and tachycardia. question infiltrate.
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the endotracheal tube is unchanged in position, <num> cm above the carinal. overlying skin <unk> and posterior lumbar fusion hardware are partially visualized. again seen is a dense left retrocardiac opacity, stable since the prior examination, reflecting left lower lobe collapse. a soft tissue mass overlying the left hemi thorax and involving the left fourth rib is again seen, better visualized on the dedicated ct performed on the same day. there is no pneumothorax.
post lumbar fusion.
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the endotracheal tube, enteric tube, right ij introducer, and right upper quadrant drain are unchanged in position. the transesophageal drain has been removed. compared to the prior cxr, the interstitial edema has nearly resolved. worsening right lung base opacity is largely due to new right lower lobe collapse in addition to a pleural effusion. there is no pneumothorax. cardiomediastinal silhouette is stable.
<unk> year old man s/p acute desat // please look for any acute pulmonary processes
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a portable frontal chest radiograph demonstrates slightly lower lung volumes with increased prominence of the cardiac silhouette and bronchovascular crowding. allowing for this and differences in technique, heart size is likely unchanged. there is increased opacity overlying the bilateral lower lobes, with evidence of a small left pleural effusion, consistent with mild pulmonary edema. a right pleural effusion is trace, if any. there is no pneumothorax. no definite focal consolidation is seen, though the presence of underlying consolidation at the left base would be difficult to exclude. old healed right sided rib fractures again noted. clips projecting over the left axilla are unchanged. the visualized upper abdomen is grossly unremarkable.
evaluate for fluid overload in a patient with a history of chf, now with shortness of breath.
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portable semi-upright radiograph of the chest demonstrates persistent small left-sided pleural effusion, which is not significantly changed. a small right-sided pleural effusion is also seen, and is slightly increased in size over the interval. again seen are multiple bilateral nodules in the lungs consistent with metastatic disease. the cardiomediastinal and hilar contours are unchanged. two chest tubes project over the left hemithorax.
<unk>-year-old female with metastatic melanoma and recurrent pleural effusions. evaluate for interval change.
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left ij central venous catheter is unchanged. the lung volume is low. pulmonary vascular engorgement and pulmonary edema have improved. left lower lobe collapse is unchanged. small to moderate pleural effusion bilaterally is unchanged. no pneumothorax.
<unk> year old woman with sepsis hemoptysis // interval change
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ap portable upright view of the chest. right ij access central venous catheter is again noted with its tip in the low svc region. minimal linear density at the left lung base is most compatible with atelectasis. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact.
<unk>f with neutropenic fever // pna?
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a left pectoral dual-chamber pacer terminates in the region of the right atrium and ventricle. the heart size is top normal. there is no pneumothorax, pleural effusion, or focal consolidation. atherosclerotic calcifications are noted in the aortic knob.
new dual-chamber pacemaker placement. evaluation for lead placement.
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heart size is mildly enlarged. the mediastinal contours are unremarkable. there is mild upper zone vascular redistribution suggestive of pulmonary vascular congestion. both hilar are mildly prominent. no focal consolidation, pleural effusion or pneumothorax is demonstrated. there are mild degenerative changes in the thoracic spine.
tachycardia.
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the right port-a-cath terminates in the lower svc near the superior caval atrial junction. there is no pneumothorax or pleural effusion. the lung volumes are normal. normal size of the cardiac silhouette. normal hilar and mediastinal structures. no pneumonia.
<unk> year old woman with metastatic pancreatic cancer. // assess port location.
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pa and lateral views of the chest provided. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
history: <unk>f with recent bronchoscopy with fever, shortness of breath // eval for infiltrate
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a tracheostomy tube is in place. there is hyperinflation consistent with background copd. the cardiomediastinal silhouette, including mild cardiomegaly and prominence of the superior mediastinum, is unchanged compared with <unk>. there is upper zone redistribution and mild vascular blurring, without other evidence of chf. there are patchy opacities at both lung bases. possible minimal blunting of the left costophrenic angle, but no gross effusion identified. again seen is calcification along the left chest wall, possibly sequela from old hemothorax. multiple clips again noted in the upper abdomen.
<unk> year old man with fever, chills, cough - being treated for copd exacerbation at snf without resolution of symptoms // eval for pneumonia
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the heart is normal in size. there is mild unfolding of the thoracic aorta. the mediastinal and hilar contours are otherwise unremarkable. the lungs appear clear. there are no pleural effusions or pneumothorax. thin flowing osteophytes are noted along the thoracic spine.
hypoxia and shortness of breath.
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tracheostomy tube is in stable position. left picc line again is seen with tip in the left brachiocephalic vein. the cardiomediastinal and hilar contours are stable. there is no pleural effusion or pneumothorax. new elevation of the left hemidiaphragm indicates volume loss. overall there has been little change in the bibasilar opacities.
ventilator associated pneumonia, now with copious secretions.
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the cardiac, mediastinal and hilar contours are normal. the lungs are clear. the pulmonary vasculature is normal. no pleural effusion or pneumothorax is present. no acute osseous abnormalities are seen.
shortness of breath.
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the cardiac, mediastinal and hilar contours are normal. pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is seen. there are mild degenerative changes in the thoracic spine.
nonproductive cough, right-sided chest pain.
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lungs are grossly clear without lobar consolidation, pleural effusion, pneumothorax, or pulmonary edema. left midlung pulmonary nodule is as seen on prior ct. mild cardiomegaly is unchanged from prior examination.
<unk>f with cough // eval for infiltrate
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et tube, ng tube, and right ij line nominal in position. no pneumothorax detected. small left pleural effusion and atelectasis at the left base may be slightly worse. atelectasis at the right base is similar or slightly improved. minimal blunting of the right costophrenic angle is unchanged. there is upper zone redistribution and mild chf, not significantly changed.
<unk> year old man with pna // interval chnage
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the lungs are clear without focal consolidation, pleural effusion or pneumothorax. there is no pulmonary edema. the heart is normal in size, and the mediastinal contours are normal.
<unk>-year-old female with left-sided chest pain, cough. evaluate for cardiopulmonary abnormality.
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again visualized is the large posterior left lung mass overlying the spine, better visualized on the recent ct. the multiple metastatic nodules are also better characterized on the recent ct. bilateral lower lung predominant interstitial opacities are present, similar to <unk> radiograph. there are stable small bilateral pleural effusions. the cardiomediastinal silhouette is stable in appearance. the bilateral hilar enlargement is due to adenopathy, unchanged from prior. the pulmonary vasculature is normal. no pneumothorax is seen.
<unk> year old man with hemoptysis, s/p biopsy on <unk> of lll mass // interval change
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frontal and lateral views of the chest are compared to previous exam from <unk>. as on prior, there are linear bibasilar opacities suggestive of atelectasis. there is no pleural effusion nor pneumothorax. the cardiomediastinal silhouette is within normal limits. osseous and soft tissue structures are grossly unremarkable.
<unk>-year-old female with fall, preceded by chest pain. c-spine tenderness.
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there are relatively low lung volumes. given this, no focal consolidation, pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.
history: <unk>f with chest pain // r/o pneumothorax
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single portable supine frontal view of the chest. the patient is very rotated. the lung bases are almost uninterpretable given the low lung volumes and bibasilar atelectasis. supine positioning is contributing to pulmonary vascular engorgement. there are small bilateral pleural effusions. no pneumothorax is seen. the cardiomediastinal silhouette is enlarged.
fever.
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low lung volumes are again noted and there is relative elevation the right hemidiaphragm. right-sided central venous catheter seen with tip over the right atrium, new since prior. there is no pneumothorax. there are diffusely increased interstitial markings throughout the lungs bilaterally. there is no effusion. cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
<unk>f with new r tunneled line // eval for line placement
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heart size is normal. the mediastinal and hilar contours are normal. the pulmonary vasculature is normal. lungs are clear. no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.
history: <unk>f with seizure // eval for acute process
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heart size appears at least moderately enlarged, but assessment is limited due to the presence of small bilateral pleural effusions, left greater than right. mediastinal and hilar contours are unremarkable. mild pulmonary vascular congestion is noted with cephalization of pulmonary vascular markings. bibasilar opacities likely reflect areas of atelectasis. no pneumothorax is identified. mild to moderate compression deformity anteriorly of an upper lumbar vertebral body is new compared to <unk> but indeterminate in age.
history: <unk>f with dyspnea on exertion, history of congestive heart failure
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a portable frontal chest radiograph demonstrates the repositioned right picc with the tip at the origin of the svc. per discussion with the iv nurse, the picc was pulled back only <num> cm, but radiographically it appears to have been withdrawn <num>-<num> cm. the remainder of the exam is unchanged, demonstrating severe bilateral homogeneous opacities consistent with pulmonary edema.
right picc with tip still in the right atrium on prior radiograph, now status post repositioning.
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as compared to radiograph from <num> day prior, pulmonary edema has progressed which is now moderate. moderate cardiomegaly. probable small pleural effusions. worsening bibasal opacities are likely atelectasis. right-sided picc line with the tip in the mid svc.
<unk> year old woman with depressed ef, vt ablation, with new sob // ?flash pulmonary edema
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the lungs are well inflated. the trachea is central. the cardiomediastinal contour is normal. the heart is not enlarged. no blunting of the costophrenic angles to suggest a pleural effusion. no areas concerning for consolidation seen. no destructive bony lesions seen.
<unk> year old man with difficult to control seizures has been having shortness of breath increasing today. // ? chemical aspiration
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interval increased density of the right lower lobe mass, likely secondary to the recent biopsy. no pneumothorax identified. there is new right lower lung zone of pleural thickening, also likely related to the biopsy. no focal consolidation, pleural effusion or pneumothorax in the left lung. the size and appearance of the cardiomediastinal silhouette is unchanged.
<unk> year old woman with rll mass. // s/p ct guided lung biopsy for a rll mass. r/o pneumothorax.
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right chest wall single lead pacing device is again noted. there is moderate cardiomegaly which is unchanged. the lungs are clear without focal consolidation, effusion, or edema. no acute osseous abnormalities.
<unk>f with confusion, infectious work up // ? pna
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there is a subtle opacity at the right mid-to-lower lung zone, which may represent infection. there is likely atelectasis in the left lower lobe. the lungs are hyperexpanded. severe emphysema is again noted. there is no pleural effusion or pneumothorax. the cardiomediastinal silhouette is normal. the bones are intact.
<unk>-year-old male with copd and dyspnea. evaluate for pneumonia.
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the lungs are clear without focal consolidation. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable. evidence of dish seen along the thoracic spine.
history: <unk>m with fevers, cough // eval pna
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assessment is somewhat limited due to patient rotation. heart size appears mildly enlarged, increased compared to the previous exam. the aorta is diffusely calcified. bronchiectasis with architectural distortion, scarring, and calcifications involving the right apex and left mid lung field as well as superior retraction of the right hila are again noted along with calcified mediastinal and right hilar lymph nodes, findings compatible with the sequela of prior granulomatous infection. new mild pulmonary edema is present. no pleural effusion or pneumothorax is identified. multiple punctate radiopaque densities again are seen overlying the left superior chest. no acute osseous abnormality is detected. calcifications in the right upper quadrant of the abdomen are compatible with gallstones.
history: <unk>m with fever
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there are no prior films in our system for comparison. the et tube is about <num> cm from the carina. the ng tube courses below the diaphragm with the tip off the film. cardiomediastinal and hilar contours are normal. there are overall low lung volumes. there is a left retrocardiac opacity as well as a right basilar patchy opacity.
<unk>-year-old with seizure and concern for aspiration.
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the heart appears borderline enlarged. the mediastinal and hilar contours appear within normal limits. there is no pleural effusion or pneumothorax. the lungs appear clear. bony structures are unremarkable.
chest pain.
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as compared to chest radiograph from the same day, low lung volumes. central opacities, slightly asymmetrically worse on the right, can be asymmetric edema or pneumonia given the history of aspiration. mild cardiomegaly. no pleural effusions or pneumothorax. severe s shaped scoliosis.
<unk> year old woman with cp, aspiration, with new hypoxia // interval change
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the lungs are clear. cardiac silhouette is normal. hilar contours are unremarkable. there is no pleural effusion or pneumothorax. the apparent increasing scoliosis centered in the thoracolumbar junction is most likely positional.
hep c cirrhosis, now with chest pain. radiating down the left flank.
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the lungs are clear. a left subclavian pic line tip is seen in the mid svc. the cardiomediastinal silhouette, hilar contours and pleural surfaces are normal. no pneumothorax or pleural effusion.
<unk> year old woman with picc line placed during prior admission. would like to re-confirm positioning. // please eval for picc placement
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no focal consolidation, pleural effusion or pneumothorax identified. the size of the cardiac silhouette is within normal limits.
<unk> year old man with cad // eval pre-op cabg, will call when patient arrives from osh
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the lungs are clear without consolidation or edema. there is no pleural effusion or pneumothorax. the cardiomediastinal silhouette is normal.
fever and cough. evaluate for pneumonia.
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pa and lateral views of the chest demonstrate clear lungs. cardiac silhouette is normal in size. no pleural effusion, pneumothorax or edema.
<unk>-year-old man with persistent cough. rule out pneumothorax.
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heart size is top normal. mediastinal and hilar contours are unremarkable. apart from subsegmental atelectasis in the right lung base, the lungs are clear and the pulmonary vasculature is normal. no pleural effusion or pneumothorax is seen. there are no acute osseous abnormalities.
new onset chest pain.
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the heart is borderline in size with a left ventricular configuration. the aorta appears calcified. there are probably trace bilateral effusions. an opacity involves the right upper lung and posterior upper and lower lungs on the lateral view, probably correlating with pneumonia involving the right upper lobe and possibly the superior segment of the right lower lobe. it is difficult to exclude some component of pneumonia at the lung bases, although streaky opacities in those areas may be more attributable to atelectasis. the bones appear demineralized. the left humeral head shows extensive bone destruction with a mixed lytic and sclerotic appearance, not fully assessed here although possibly post-traumatic, including a large loose body projecting below the coracoid. moderate rightward convex curvature is centered along the upper thoracic spine.
diffuse body aches. question pneumonia.
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ap portable semi upright view of the chest. there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. degenerative changes at the shoulders partially imaged.
<unk>f with fever and ams // eval for pna
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an et tube is present. the carina is not well visualized, but the tip lies at the level of the mid clavicular heads probably approximately <num> cm above the carina. an ng tube is present, tip beneath the diaphragm, overlying the stomach. right and? left chest tubes and mediastinal drains are present. right ij sheath present, tip over proximal svc. the right ij swan-ganz catheter is been removed. no pneumothorax detected. inspiratory volumes are slightly low. the cardiomediastinal silhouette is enlarged the probably unchanged allowing for differences in technique. there is mild vascular blurring, but no definite chf. again seen is dense opacity abutting the left upper chest wall and effacing much of the upper zone. there is probably also a left perihilar opacity which in retrospect is unchanged. increased retrocardiac density again noted. the left costophrenic sulcus is obscured, but this may be due to overlying materials rather than the significant left effusion. at the right base, there is new hazy opacity, possibly reflecting a small pleural effusion together with some atelectasis.
<unk> year old man with increased peep requirement and possible lul collapse // interval change
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the lung volumes are low. allowing for technique, the cardiac, mediastinal and hilar contours appear unchanged. the heart size is difficult to evaluate. aside from a linear opacity projecting over the left mid lung, suggesting minor lingular atelectasis or scarring, the lungs appear clear. there are no pleural effusions or pneumothorax. the bony structures are unremarkable.
fever and chronic cough.
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frontal and lateral views of the chest. the lungs are clear. there is no pneumothorax nor effusion. cardiomediastinal silhouette is within normal limits. radiopaque densities seen in the mid to distal esophagus with additional focus just past the ge junction. this may represent patient's esophageal ph probe.
<unk>-year-old female with pain status post egd, bravo probe placement.
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the lungs are clear. nodular opacities projecting over the lung bases are compatible with nipple shadows. cardiomediastinal silhouette is within normal limits. no acute osseous abnormalities.
<unk>m with altered mental; status // r/o bleed
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new left chest subclavian atrial ventricular defibrillator leads follow their expected courses. there is no pneumothorax, pleural effusion or mediastinal widening. lungs are clear. moderate to severe cardiomegaly is unchanged. there is no pulmonary edema or pulmonary vascular congestion.
<unk>-year-old man with new pacemaker.
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the patient is status post prior median sternotomy and cabg. a left chest wall dual lead pacemaker is present. a right central venous catheter is unchanged, the tip extending to the superior cavoatrial junction. no focal consolidation, pleural effusion or pneumothorax identified. mild unchanged central pulmonary vascular congestion. the size and appearance of the cardiomediastinal silhouette is unchanged. partially evaluated bilateral shoulder prostheses.
<unk>m w/large volume resuscitation, please eval for pulm edema
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ap single view of the chest has been obtained and is analyzed in direct comparison with the next preceding similar study of <unk>. the previously described two right-sided chest tubes placed following decortication procedure remain in unchanged position and the findings are unchanged. no pneumothorax has developed. the local small amount of chest wall emphysema remains. no new abnormalities are seen. the on previous examination identified plate atelectasis in the mid left lung field has disappeared and only a peripheral small plate atelectasis remains. no new abnormalities are seen.
<unk>-year-old male patient with progressive shortness of breath and dyspnea on exertion for six weeks, levaquin for pneumonia, right pleural effusion status post thoracocentesis on <unk>, now with persistent effusions likely emphysema. status post vats decortication. evaluate for interval change.
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frontal and lateral radiographs of the chest demonstrate well expanded, clear lungs. the cardiomediastinal and hilar contours are unremarkable. there is no pneumothorax, pleural effusion, or consolidation. mild scoliosis is again seen, and appears unchanged.
history: <unk>f with h pyolri, abd pain // evaluate for acute process
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frontal and lateral views of the chest. biapical scarring is again noted. calcification is seen in the right mid lung laterally. left basilar linear opacities suggestive of atelectasis versus scarring. the lungs are otherwise clear. cardiomediastinal silhouette is within normal limits. no acute osseous abnormality is identified.
<unk>-year-old male with cholangiocarcinoma on chemotherapy, with fevers and chills.
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lungs are well inflated and. the cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. there is no pleural effusion or pneumothorax. visualized upper abdomen is unremarkable. surgical clips are noted in the upper abdomen. osseous structures are grossly intact.
chest pain, evaluate for pneumonia or pneumothorax.
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subtle patchy left base retrocardiac opacity is seen which may be due to atelectasis but subtle infectious process is not excluded. no pleural effusion or pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable.
history: <unk>f with chest pain // cardiopulmonary process?
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there is no focal consolidation, effusion, or pneumothorax. the cardiomediastinal silhouette is normal. imaged osseous structures are intact. no free air below the right hemidiaphragm is seen.
history: <unk>f with chest discomfort and fever // pneumonia?
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heart size is mildly enlarged. the aorta is calcified at the knob. mediastinal and hilar contours are otherwise unremarkable. pulmonary vasculature is not engorged. minimal atelectasis is noted in the left lung base. no focal consolidation, pleural effusion or pneumothorax is present.
history: <unk>f with shortness of breath
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there are low lung volumes. small bilateral pleural effusions are seen, best appreciated on the lateral view. no pneumothorax is seen. the cardiac and mediastinal silhouettes are unremarkable. no pulmonary edema is seen. coils are noted overlying the right upper abdomen.
history: <unk>f with hx liver ca s/p radiation/chemo, p/w syncope and right abdominal pain // eval for acute process
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in comparisons to the prior study, there is interval development of large dense left mid and lower lung opacification consistent with a large pleural effusion and likely increased size of known left juxta hilar mass. this is associated with contralateral shift of the heart and mediastinum. small right pleural effusion and right basilar atelectasis have increased. no pneumothorax.
<unk> year old woman with met nsclc // r/o acute intrathoracic disease