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MIMIC-CXR-JPG/2.0.0/files/p14670692/s59523505/28e4868c-166570ea-d0f1e104-6306ba36-ad102b1c.jpg
interval placement of a right-sided pacemaker, with leads terminating in the right atrium and right ventricle. no pneumothorax.
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elevation of the right hemidiaphragm with low lung volumes and atelectasis.
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in comparison with the study of to , there again are bilateral pleural effusions, more prominent on the right, with basilar atelectasis.
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<num>) stable cardiomegaly and stable left base atelectasis/scarring. probable background copd. <num>) no acute pulmonary process identified. <num>) hiatal hernia and chronic compression fractures. <num>) findings seen on chest ct not well visualized radiographically. also, equivocal prominence right hilum. please see comment above.
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no acute abnormality to explain the patient's new hemoptysis.
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no acute cardiopulmonary process.
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previous consolidation in the right middle lobe has improved. lungs are essentially clear of the multi focal abnormality present on , probably viral or mycoplasma pneumonia. hyperinflation is consistent with either emphysema or small airway obstruction. cardiomediastinal and hilar silhouettes and pleural surfaces are normal. moderately severe compression of an upper thoracic vertebral body which developed between and is unchanged. mild gaseous distention of the mid esophagus is a recurrent feature and while it could be normal in a patient of this age might indicate swallowing dysfunction. clinical correlation advised.
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normal chest xray without evidence of tuberculosis.
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as compared to the previous radiograph, the second image documents the correct position of the dobbhoff catheter in the middle parts of the stomach. no complication is present. no pneumonia, no pulmonary edema, no pneumothorax. the appearance of the lung parenchyma and the cardiac silhouette is constant.
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no acute cardiopulmonary process.
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cardiomegaly with pulmonary edema and small bilateral effusions.
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no acute cardiac or pulmonary process. unchanged mild cardiomegaly. deviation of the trachea to the right at the level of the thoracic inlet may be due to a left-sided thyroid nodule. correlation with physical exam is recommended. impression point #<num> was emailed to the ed qa nurse at on.
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no acute cardiopulmonary process.
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no acute cardiopulmonary process.
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again seen lingular nodule previously characterized as a hamartoma, may be slightly increased in size. no focal consolidation to suggest pneumonia.
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no radiographic evidence of pneumonia or new pulmonary abnormalities.
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linear opacities in the left lower lobe likely represent atelectasis although infection is note entirely excluded.
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lines and tubes in satisfactory position. stable small layering left pleural effusion.
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a new right lung base infiltrate is concerning for pneumonia. a left picc line terminates at the upper svc.
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stable left apical pneumothorax
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no acute cardiopulmonary process.
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no acute cardiopulmonary process.
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the lung volumes are normal. normal size of the cardiac silhouette. normal hilar and mediastinal structures. moderate scoliosis with asymmetry of the ribcage. no pleural effusions. no pulmonary edema. no pneumonia.
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left upper lobe pneumonia. this should be followed to imaging resolution.
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right lower lobe pneumonia. recommendation(s): follow-up chest radiograph in weeks after completion of antibiotic therapy to ensure resolution.
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small bilateral pleural effusions with subjacent atelectasis.
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no acute cardiopulmonary process.
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no pneumonia, edema, or effusion.
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there to chest radiographs. patient is a severely rotated to the left, making it difficult to assess extent of left lower lobe atelectasis. small left pleural effusion may be present. no pneumothorax or mediastinal widening. transvenous other right ventricular pacer lead in standard placement. no pneumothorax. right lung clear. heart mildly enlarged.
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normal examination of the chest. gaseous distention of the colon concerning for ileus.
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unremarkable chest radiograph.
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no acute cardiopulmonary process.
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as compared to the previous radiograph, no relevant change is seen. low lung volumes. massive cardiomegaly, bilateral pleural effusions and mild pulmonary edema. areas of atelectasis at both the left and the right lung bases are unchanged. the monitoring and support devices, including the tracheostomy tube, is in unchanged position.
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no acute cardiopulmonary process.
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left-sided chest tube to water seal, <num> cm left apical pneumothorax present.
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no evidence of acute disease.
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ap chest compared to : severe consolidation at the base of the left lung which worsened from to has not cleared. could be either persistent lobar collapse or pneumonia. moderate to severe cardiomegaly and mediastinal and pulmonary vascular engorgement indicate persistent cardiac decompensation, but there is no pulmonary edema. an -mm wide elliptical opacity projecting over the right mid lung and the seventh posterior rib could be a new, acute lung nodule, as such infectious. feeding tube is looped in the upper stomach, which is moderately distended with air and fluid.
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no acute cardiopulmonary process. right basilar and lingular scarring/atelectasis.
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hyperinflated lungs suggests small airways obstruction; no evidence of pneumonia.
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no evidence of rib fractures. stable pulmonary nodules. decreased left pleural effusion. post esophagectomy with gastric pull-through.
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as compared to the previous radiograph, there is unchanged evidence of mild pulmonary edema. no new focal parenchymal opacities. but blunting of the costophrenic sinuses could suggest the presence of small pleural effusions. no new focal parenchymal opacities. moderate cardiomegaly. the dobbhoff catheter and the right picc line are constant.
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tiny left apical pneumothorax. left rib fractures not clearly visualized.
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no acute cardiopulmonary process.
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dobbhoff tube within the stomach.
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no acute intrathoracic process.
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interval placement of a left-sided chest tube projecting over the left hemithorax.
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in comparison with the study of , there is little change and no evidence of acute pneumonia, vascular congestion, or pleural effusion.
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lucencies along the underside of <num> contiguous right middle ribs posteriorly, especially the , could be erosive malignancy. findings are new since. bone detail views recommended. there is no pleural effusion or pneumothorax. heart size is normal. lungs clear.
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no radiographic evidence for pneumonia or pulmonary edema.
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small right pleural effusion has developed since following removal of the right thoracostomy tube. there is no appreciable pneumothorax. atelectasis persists at the base of the postoperative right lung and the left lung. cardiomegaly is severe, but there is no pulmonary edema.
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large area of consolidation left lower lungs increased since now accompanied by moderate to large left pleural effusion. findings are concerning for pneumonia. pulmonary vascular congestion and moderate right pleural effusion have increased, along with right basal atelectasis. severe cardiomegaly is chronic. no pneumothorax.
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no pneumonia.
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right upper lobe cavity again noted with wispy opacity in the right lower lung concerning for developing focus of pneumonia.
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as compared to the previous radiograph, the right chest tube has been removed. the pleural effusion has again minimally increased, causing a mild atelectasis at the right lung bases. on the left, the effusion is constant an also constant is the retrocardiac atelectasis. borderline size of the cardiac silhouette. the patient has been extubated.
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swan-ganz catheter still extends beyond the mediastinum. layering moderate right pleural effusion and increased right basilar atelectasis. persistent left lower lobe atelectasis.
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substantial new left-sided pleural effusion with areas of opacification and volume loss, probably compatible with atelectasis, although not entirely specific.
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no radiographic evidence for acute cardiopulmonary process.
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severe rotary dextroscoliosis of the thoracolumbar spine. bibasilar atelectasis.
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no good evidence of tb infection. in the absence of evidence of adenitis elsewhere, the right infrahilar opacity is unlikely to be isolated adenopathy due to tb. it is much more likely to be a pericardial cyst. consider chest ct if there is evidence of adenopathy elsewhere.
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status post removal of the endotracheal tube, otherwise unchanged.
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as compared to the previous image, no relevant change is seen. mild bilateral pleural effusions. moderate cardiomegaly. the monitoring and support devices are in unchanged position. mild fluid overload is constant. extensive retrocardiac atelectasis.
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no radiographic evidence for acute cardiopulmonary process. no pneumonia.
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small left apical pneumothorax unchanged. stable moderate postoperative widening cardiomediastinal silhouette and stable moderate right pleural effusion. mild pulmonary edema unchanged since earlier in the day, improved since. no right pneumothorax. right jugular line ends in the upper svc.
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as compared to the previous radiograph, the patient has received a left pectoral pacemaker. the course of the leads is unremarkable, <num> lead projects over the right atrium and <num> over the right ventricle. no complications, notably no pneumothorax. unchanged size of the cardiac silhouette. no pulmonary edema. no pneumonia. unchanged elongation of the descending aorta.
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normal chest x-ray.
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no acute cardiopulmonary process.
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new endotracheal tube terminates <num> cm above the carina. enteric tube terminates below the diaphragm. worsened pulmonary edema since the study <num> hours prior with bilateral pleural effusions and adjacent opacities, which could represent atelectasis, infection, or aspiration.
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compared to chest radiographs since most recently. lungs fully expanded and clear. no pneumonia. cardiac and hilar silhouettes and pleural surfaces are normal. ascending thoracic aorta is somewhat dilated or tortuous producing a lateral convexity in the right mediastinal contour, unchanged since. moderate hiatus hernia probably larger today.
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the final position of the dobbhoff tube is in the stomach. et tube tip is <num> cm above the carina. low lung volumes and perihilar opacities are unchanged.
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no evidence of acute cardiopulmonary disease. suspected minor right basilar atelectasis.
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no acute intrathoracic process.
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cardiac and mediastinal contours are stable. lungs appear well aerated without evidence of focal airspace consolidation, pleural effusion or pneumothorax. surgical clips are again seen in the region of the right superior mediastinum. clips in the right upper quadrant consistent with prior cholecystectomy. prominent amount of gas in the splenic flexure.
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cardiomegaly and mild to moderate pulmonary edema in the background of possible pulmonary fibrosis. suggest comparison to prior chest imaging, particularly any chest ct scans.
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orogastric tube in appropriate position. no significant changes since prior study obtained <num> minutes previously.
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in comparison with the study of , there is no definite pneumothorax. no pneumonia, vascular congestion, or pleural effusion.
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no pneumonia.
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no acute cardiopulmonary process.
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normal chest radiograph.
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no acute cardiopulmonary abnormality.
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no acute cardiopulmonary process.
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increased chf
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subtle linear opacities in the right upper lobe could represent atypical pneumonia or scarring. recommend followup to resolution.
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no pneumonia.
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pulmonary vascular plethora, increased compared with. patchy left base opacity also increased, consistent with left lower lobe collapse and/or consolidation or an area of aspiration. lytic lesion left proximal humerus. this is more completely depicted on left shoulder radiographs dated.
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minimal increase in the left lower lobe patchy opacification, which could be due to mild worsening chronic changes or a superimposed new infiltrate.
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no acute cardiopulmonary process.
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low lung volumes are even lower today than on , but the lungs are much more clear indicating resolution of previous mild to moderate pulmonary edema. severe cardiomegaly is chronic. mediastinal vasculature is chronically engorged, but improved today compared to. left pic line is now curled at the level of the superior cavoatrial junction and may enter the atrial appendage.
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interval resolution of moderate to severe pulmonary edema
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no acute cardiopulmonary process.
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left basilar atelectasis. otherwise, normal.
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in comparison with the study of , there is little change and the appearance of the right upper lobe consolidation bounded inferiorly by the minor fissure. pigtail catheter remains in place without definite pneumothorax. remainder of the study is unchanged.
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no acute cardiopulmonary process.
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large hiatal hernia with bibasilar atelectasis.
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bibasilar subsegmental atelectasis. no focal consolidation to suggest pneumonia.
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lungs are clear. heart is normal size. borderline right hilar enlargement and mediastinal contours suggesting adenopathy in the aortopulmonic window are if anything less prominent today than in. any adenopathy would therefore be of no active clinical concern. there is no pleural effusion.
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no pneumothorax.
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no acute cardiopulmonary process. no pneumothorax.
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no acute cardiopulmonary process.
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no overt pulmonary edema. patchy right basilar opacity new since the prior study, could be due to infection and/ or aspiration. dedicated pa and lateral views would be helpful for further evaluation, if/when patient able.
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no acute intrathoracic process.