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mimic_chest_xray_v_1_test

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chest x-ray; 'No Finding'

Endotracheal tube tip in good position. Enteric tube below diaphragm, tip not included on the radiograph. Increased heart size, stable. Decreased pulmonary vascularity since prior exam. Small left pleural effusion, similar. Decreased bibasilar opacities. Suggestion of IABP in the lower descending thoracic aorta, or other projected catheter, stable.

chest x-ray; 'Atelectasis'; 'Pleural Effusion'; 'Pneumothorax'

As compared to the previous radiograph, the pre-existing left pleural effusion has substantially decreased in extent. There is no clear evidence for the presence of a left pneumothorax. Moderate remnant left lower lobe atelectasis. The right lung is unchanged, no cardiomegaly.

chest x-ray; 'No Finding'; 'Support Devices'

As compared to the previous radiograph, the previously positioned left internal jugular vein catheter has been substantially pulled back. Catheter tip is now positioned in the left cervical region. The catheter needs to be repositioned. No evidence of complications. Otherwise, unchanged radiograph. The endotracheal tube and nasogastric tube are constant.

chest x-ray; 'Edema'

In comparison with the earlier study of this date, there is a slight decrease in the pulmonary edema, though significant elevation of pulmonary venous pressure is still present. Otherwise little change.

chest x-ray; 'Atelectasis'; 'Cardiomegaly'; 'Pleural Effusion'; 'Support Devices'

Indwelling tracheostomy tube has approximately 3 cm intra tracheal excursion. Mediastinal drainage catheter still in place. Probable new left lower lobe atelectasis. Small right pleural effusion increased. No definite pulmonary edema. Heart size is distorted by patient positioning. No pneumothorax.

chest x-ray; 'Atelectasis'; 'Lung Opacity'; 'Support Devices'

CHEST, SINGLE AP PORTABLE VIEW. An NG type tube is present, tip overlying the stomach. There is possible minimal upper zone re-distribution, without overt CHF. There is bibasilar atelectasis, including retrocardiac density, with partial obscuration of left hemidiaphragm. No gross effusion is identified. Minimal blunting of both right and left costophrenic angles may, however, be present. Compared with ___ at 5 a.m., opacity at the left base is slightly increased. Irregular density in the region of the GE junction is new, ? residual oral contrast or other artifact outside of the patient.

chest x-ray; 'Atelectasis'; 'Cardiomegaly'; 'Support Devices'

Bibasilar atelectasis have improved. There are persistent low lung volumes. Mild cardiomegaly is accentuated by the projection. There is no evident pneumothorax or enlarging effusions. Right IJ catheter tip is in the cavoatrial junction.

chest x-ray; 'No Finding'; 'Support Devices'

ET tube tip is 5 cm above the carinal. Left PICC line tip is at the level of mid SVC. Right internal jugular line tip is at the level of cavoatrial junction. Right chest tube is in place. Left chest tube is in place. There is mild improvement in the overall aeration of the right lung and unchanged appearance of the left lung.

chest x-ray; 'Atelectasis'; 'Cardiomegaly'; 'Pleural Effusion'; 'Pneumothorax'

Compared to prior chest radiographs since ___, most recently ___. Previous moderate right pleural effusion is substantially smaller. New small right basal pneumothorax absent a fluid level, suggests that the fluid and air are loculated separately. Small volume of pneumoperitoneum beneath the right hemidiaphragm is smaller. Bibasilar atelectasis is moderate on the right, small on the left. Heart size is top-normal. Neo esophagus is filled with air.

chest x-ray; 'Lung Opacity'; 'Pleural Effusion'

Cardiomediastinal contours are stable in appearance. Multifocal poorly defined pulmonary opacities are again demonstrated, with increased confluence in the left upper lobe but improved aeration in the left lower lobe due to a combination of improving pulmonary opacities and apparent decrease of left pleural effusion. Pulmonary and pleural abnormalities on the right appear relatively similar to the prior study. Observed findings in the lungs are in keeping with the history of pneumonia.

chest x-ray; 'Consolidation'; 'Lung Opacity'; 'Pleural Effusion'; 'Pneumonia'; 'Support Devices'

Comparison is made with prior study performed on same day earlier in the morning. Moderate vascular congestion has increased. Right parahilar consolidation and left lower lobe opacities have increased consistent with worsening pneumonia. Small bilateral pleural effusions are grossly unchanged, largely on the left side. The cardiomediastinal contours are unchanged. Left peripheral catheter is in unchanged position.

chest x-ray; 'Cardiomegaly'; 'Consolidation'; 'Support Devices'

As compared to the previous radiograph, the right PICC line is in unchanged position, with the tip projecting over the mid to low SVC. The course of the line is also are none changed. Right upper mediastinal widening as well as the parenchymal consolidation in the right upper lobe is constant in appearance. The paramediastinal clips are constant. No new parenchymal opacities. No change in appearance of the cardiac silhouette.

chest x-ray; 'Lung Lesion'; 'Lung Opacity'; 'Pneumonia'

Left-sided Port-A-Cath is unchanged in position. Lungs are without evidence of focal airspace consolidation to suggest pneumonia. No pneumothorax or pulmonary edema. No pleural effusions. 3mm nodular opacity in the left peripheral lower lung corresponds to a calcified nodule on recent chest CT ___ and therefore is consistent with a granuloma. Stable cardiac and mediastinal contours.

chest x-ray; 'Support Devices'

Patient is status post left LUNG SURGERY, with LONG-STANDING mediastinal shift to the left, UNCHANGED. The right lung is SEVERELY EMPHYSEMATOUS. There is no pleural effusion or pneumothorax. APICAL THORACOSTOMY TUBE IN PLACE.

chest x-ray; 'Enlarged Cardiomediastinum'; 'Support Devices'

AP chest compared to ___: Heart size has increased but is still normal. Lungs are clear. Bulbous right hilus is probably due to vascular dilatation. There is no evidence elsewhere of central lymph node enlargement. A right-sided central venous catheter ends in the upper SVC. Tortuous mediastinal vessels explain the bulging rightward convex contour of the mediastinum in the thoracic inlet.

chest x-ray; 'Pleural Effusion'

There is some limitation due to patient rotation to the right. This obscures the right lung base. There is patchy density in the right mid and lower lung zones. There is an effusion present on the right. There is no pneumothorax or CHF.

chest x-ray; 'No Finding'

Patient is status post median sternotomy, transcatheter aortic valve replacement, and mitral valve replacement. Cardiac, mediastinal and hilar contours are normal. Lungs are hyperinflated without focal consolidation. Pulmonary vasculature is not engorged. There is no pleural effusion or pneumothorax. No acute osseous abnormality is visualized.

chest x-ray; 'Pneumothorax'; 'Support Devices'

Comparison to ___. In the interval, the patient has received a feeding tube. The course of the tube is unremarkable, the tip projects over the middle parts of the stomach. No complications, notably no pneumothorax. Otherwise unchanged radiograph.

chest x-ray; 'Atelectasis'; 'Cardiomegaly'; 'Consolidation'; 'Edema'; 'Lung Opacity'; 'Pleural Effusion'; 'Support Devices'

Increasing opacities in the lower lobes are a combination of increasing pleural effusions, adjacent atelectasis and edema. Otherwise diffuse bilateral extensive consolidations are unchanged. Cardiomegaly is stable. Lines and tubes are in unchanged standard position.

chest x-ray; 'Atelectasis'; 'Cardiomegaly'; 'Edema'; 'Pleural Effusion'; 'Pneumonia'

As compared to the previous radiograph, there is no relevant change. The pleural effusions have slightly increased. The signs indicative of pulmonary edema are stable. Stable is the moderate cardiomegaly. Areas of atelectasis are unchanged. No evidence of new parenchymal opacity suggesting pneumonia.

chest x-ray; 'Atelectasis'; 'Cardiomegaly'; 'Edema'; 'Pleural Effusion'; 'Support Devices'

The lung volumes are low. Moderate cardiomegaly. Widening of the vascular structures, bilateral areas of atelectasis, combines to a small pleural effusions. Overall, the findings are indicative of moderate pulmonary edema. No evidence of pneumonia. No pneumothorax. Right internal jugular vein catheter with tip projecting over the upper SVC.

chest x-ray; 'Atelectasis'; 'Pneumothorax'; 'Support Devices'

AP chest compared to ___ through ___ at 5:20 a.m. Left upper lobe has substantially reexpanded, following insertion of endotracheal tube, but the left lower lobe is still largely collapsed and there is a new left apical pneumothorax. Atelectasis has also worsened in the right lower lobe. Heart is normal size. Nasogastric drainage tube ends in the stomach. ET tube in standard placement. Dr. ___ was paged at 12:20 p.m., one minute following recognition of the findings.

chest x-ray; 'Cardiomegaly'; 'Consolidation'; 'Pleural Effusion'; 'Pneumonia'; 'Support Devices'

Moderate-to-severe cardiomegaly is stable since ___. Transvenous pacer leads are in standard position in right atrium and right ventricle. There is an abandoned right-sided lead. A consolidation in the right upper lobe is consistent with pneumonia. There is mild vascular congestion. There is no pneumothorax. Bilateral pleural effusions are small. Sternal wires are aligned. There is valve replacement. Findings were discussed with Dr. ___ by phone on ___ at 10:50 a.m.

chest x-ray; 'Cardiomegaly'; 'Consolidation'; 'Edema'; 'Pleural Effusion'; 'Support Devices'

Comparison to ___. Increase in extent of both the left and the right pleural effusion. The right chest tube has been pulled back. Areas of consolidation at the lung bases to also increase. Unchanged mild to moderate pulmonary edema. The heart border can no longer be clearly visualized.

chest x-ray; 'Edema'; 'Lung Opacity'; 'Pleural Effusion'; 'Support Devices'

Support lines and tubes are unchanged in position. Cardiomediastinal silhouette is within normal limits. There are bilateral pleural effusions and a left retrocardiac opacity. There has been mild improvement of the pulmonary interstitial edema.

chest x-ray; 'Atelectasis'; 'Lung Opacity'; 'Pleural Effusion'

In comparison with the study of ___, the upper right lung and mediastinum are obscured by the head of the patient. Continued opacification at the left base consistent with pleural fluid and left lower lobe atelectasis. Again, in the absence of a lateral view would be difficult to unequivocally exclude superimposed pneumonia.

chest x-ray; 'Atelectasis'

Lung volumes are lower. Mild elevation of the right hemidiaphragm persists. Atelectasis explains greater opacification lower lungs. The heart is top-normal in size and there is greater distention of pulmonary and mediastinal vasculature, but no pulmonary edema. . There is no pneumothorax or appreciable pleural effusion.

chest x-ray; 'Atelectasis'; 'Lung Opacity'

1. Probable CHF, even allowing for low inspiratory volumes. 2. Bibasilar atelectasis. The possibility of early pneumonic infiltrate would be difficult to exclude in this setting.

chest x-ray; 'Atelectasis'; 'Lung Opacity'; 'Support Devices'

Hardware is seen within the cervical spine. There is a right-sided PICC line with the distal lead tip in the distal SVC. There is a left retrocardiac opacity. Atelectasis at the lung bases remain. No pneumothoraces are seen.

chest x-ray; 'No Finding'; 'Support Devices'

Again seen are the findings compatible with ileus and abnormal position of the NG tube with tip being coiled in the distal esophagus with the tip pointing upward. There is no significant change compared to the study from ___ hr prior

chest x-ray; 'Atelectasis'; 'Cardiomegaly'; 'Support Devices'

As compared to the previous radiograph, no relevant change is seen. On today's image, the patient is slightly rotated to the right causing artificial enlargement of the cardiac silhouette. In addition, a small platelike atelectasis at the left lung bases has newly appeared. However, there is no evidence of pneumonia. No pleural effusions. No pulmonary edema. No pneumothorax.

chest x-ray; 'Consolidation'; 'Pneumothorax'; 'Support Devices'

Left chest tube is in place. Cardiomediastinal silhouette is stable. Left basal consolidation is noted with subcutaneous air that appears to be decreased since the prior study. The most likely interval decrease in distal pneumothorax as well.

chest x-ray; 'Cardiomegaly'; 'Lung Opacity'; 'Pleural Effusion'; 'Support Devices'

Severe cardiomegaly which worsened between ___ and ___ is essentially stable. Upper lobe pulmonary vessels are mildly dilated. Greater opacification at the lung bases could be atelectasis and early edema, but aspiration, vertically in the left lower lobe is a real possibility. Small bilateral pleural effusions are stable. No pneumothorax. ET tube in standard placement. Esophageal drainage tube passes into the stomach and out of view.

chest x-ray; 'Pleural Other'; 'Pneumothorax'

The previous right apical pneumothorax is no longer visualized. Compared to the prior radiograph, the right IJ line and NG tube have been removed. No change in positioning of the aortic valve prosthesis. Diffuse bilateral pulmonary opacifications with bilateral lung hyperexpansion are consistent with emphysema and basal fibrosis, as seen on the CT of ___. No pleural effusions or focal consolidation.

chest x-ray; 'Pleural Effusion'

The previously seen bibasal pleural effusions are no longer apparent. Prominence of the pulmonary hila and haziness of pulmonary vascular is consistent with pulmonary vascular congestion. An intra-aortic balloon pump is in-situ. The balloon is distended on the current image. Bibasal atelectasis is likely related to the prior effusions. The 2 right lower lobe pulmonary nodules seen on the prior CT are not clearly seen on the current study.

chest x-ray; 'Atelectasis'; 'Pneumothorax'; 'Support Devices'

Left pigtail pleural catheter remains in place, with interval decrease in size of loculated lateral left hydro pneumothorax. Tiny right apical pneumothorax has decreased in size since recent study. Otherwise similar appearance of the chest compared to the previous study except for slight worsening of bibasilar retrocardiac atelectasis.

chest x-ray; 'Pneumonia'

Exam is limited by low lung volumes, scoliosis and suboptimal positioning. With this limitation in mind, cardiomediastinal contours are grossly within normal limits. Lungs are clear except for predominately linear opacities at the left base favoring atelectasis over infectious pneumonia. Surgical clips in the upper paratracheal region may reflect previous thyroid surgery.

chest x-ray; 'Atelectasis'; 'Pleural Effusion'; 'Support Devices'

Unchanged evidence of a large pleural effusion, occupying approximately ___% of the right hemi thorax. Subsequent right lower lobe atelectasis. Unchanged position of the monitoring and support devices. Unchanged normal appearance of the left lung and

chest x-ray; 'Cardiomegaly'; 'Support Devices'

A right transjugular pulmonary artery catheter ends in the proximal right pulmonary artery, well beyond the pulmonic valve. Mild cardiomegaly stable. Lungs are clear. There is no pleural effusion or pneumothorax.

chest x-ray; 'No Finding'; 'Support Devices'

Portable semi-upright radiograph of the chest demonstrates low lung volumes with resulting bronchovascular crowding. The cardiomediastinal and hilar contours are unchanged. The aorta is tortuous. There is no pneumothorax, pleural effusion, or consolidation. A right-sided internal jugular central venous line ends at the upper SVC. A nasogastric tube ends in the stomach with the last side port at the GE junction.

chest x-ray; 'Cardiomegaly'; 'Pleural Effusion'; 'Pneumonia'

Cardiomegaly is substantial. Bilateral pleural effusions are unchanged, right more than left. Substantial distension of the pulmonary arteries is noted, most likely representing pulmonary hypertension. No discrete area of focal consolidation to suggest to suggest infectious process noted.

chest x-ray; 'No Finding'

Patient is status post median sternotomy and cardiac valve replacement. The lungs remain hyperinflated, suggesting chronic obstructive pulmonary disease. No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac silhouette remains moderately enlarged. Mediastinal contours are stable. No pulmonary edema is seen.

chest x-ray; 'Atelectasis'; 'Cardiomegaly'; 'Edema'; 'Lung Lesion'; 'Lung Opacity'

As compared to the previous radiograph, the patient is after bronchoscopy. There is relatively extensive presence of post-bronchoscopy right-sided parenchymal opacities, likely reflecting combination of edema and hemorrhage. Close radiographic monitoring for resolution is required. The changes surround the 3-cm nodule seen in the right upper lobe. There is no pleural effusion. The lung volumes are low. Moderate cardiomegaly with mild areas of atelectasis at both the left and the right lung bases.

chest x-ray; 'No Finding'

Compared to the prior study there is no significant interval change.

chest x-ray; 'Edema'; 'Lung Opacity'

As compared to the previous radiograph, there is unchanged evidence of moderate pulmonary edema as well as of a focal parenchymal opacity in the left mid and lower lung. No larger pleural effusions.

chest x-ray; 'Lung Opacity'

The patient remains intubated, the endotracheal tube is now approximately 5 cm above the level the carina. A nasoenteric tube is incompletely visualized, the tip lies below the left diaphragm. Lung volumes are unchanged. There are diffuse bilateral hazy airspace opacities, slightly improved when compared to the prior study. As previously this could reflect pulmonary contusion, aspiration and/or atelectasis. No definite effusion seen but the left costophrenic angle is not visualized. No pneumothorax. No rib fracture seen.

chest x-ray; 'Cardiomegaly'; 'Lung Opacity'; 'Support Devices'

As compared to the previous radiograph, there is a minimal improvement with a decrease in extent of the pre-existing opacities in the bilateral perihilar areas. The other opacities are still seen in unchanged manner. Unchanged size of the cardiac silhouette. Unchanged left PICC line.

chest x-ray; 'Atelectasis'; 'Lung Opacity'; 'Pleural Effusion'; 'Pneumonia'

In comparison with the study of ___, there is increasing opacification at the bases, most likely reflecting atelectasis and effusion. However, in the appropriate clinical setting, superimposed pneumonia would certainly have to be considered.

chest x-ray; 'No Finding'

Left IJ catheter ends in the upper SVC. Visualized upper segment of the posterior spinal fusion hardware is intact, but study is not designed for adequate assessment of hardware. Interval removal of endotracheal and nasogastric tubes. Normal cardiomediastinal and hilar contours. Normal pleural surfaces. Lungs are clear. No pneumonia or pleural effusion.

chest x-ray; 'Cardiomegaly'; 'Support Devices'

In comparison with the study of ___, the endotracheal and nasogastric tubes have been removed. Other monitoring support devices are unchanged. Continued low lung volumes accentuates the enlargement of the cardiac silhouette and mild to moderate vascular congestion. Blunting of both costophrenic angles is again seen. No evidence of acute pneumonia.

chest x-ray; 'Cardiomegaly'; 'Edema'; 'Support Devices'

Tracheostomy tube terminates approximately 5.7 cm above the carinal. Right-sided PICC terminates at the cavoatrial junction. There are persistent low lung volumes with bilateral diffuse interstitial opacities compatible with interstitial edema with no significant interval change. No pleural effusions. Stable cardiomegaly. Bony thorax is unchanged.

chest x-ray; 'Lung Opacity'; 'Support Devices'

Severe pulmonary opacification in the right lung which worsened on ___ has progressed since earlier in the day. I do not believe there has been any interval decrease in the volume of fluid in the left pneumonectomy space to suggest a stump leak. There is no right pneumothorax. Mediastinum is still shifted mildly into the left hemi thorax. ET tube in standard placement. Left subclavian infusion port and PIC line end in the lower and mid SVC respectively.

chest x-ray; 'Pneumothorax'; 'Support Devices'

In comparison with the study of ___, there has been removal of the previous chest tube that hand insertion of a pleural pigtail catheter. The overall haziness of the right hemithorax has decreased, consistent with drainage of pleural fluid. There appears to be a pleural line in the right apex without definite vessels above it, consistent with a small apical pneumothorax.

chest x-ray; 'Atelectasis'; 'Lung Opacity'; 'Pleural Effusion'; 'Support Devices'

AP chest compared to ___ at 4:01 p.m.: New large scale opacification of the left lower lobe is probably collapse. Peribronchial opacification right lower lobe probably aspiration or pneumonia, emphysema is severe. Heart top normal. Small left pleural effusion is new. No pneumothorax. Tip of the endotracheal tube is no less than 7.5 cm from the carina and should be advanced 2 cm for more secured seating. Right jugular line ends at the junction of brachiocephalic veins. No pneumothorax.

chest x-ray; 'Lung Opacity'; 'Pneumonia'; 'Support Devices'

In comparison with the study of ___, the monitoring and support devices are stable. There is increasing opacification at the left base. Although some of this could reflect pleural fluid and atelectasis, in the appropriate clinical setting superimposed pneumonia must be seriously considered.

chest x-ray; 'Atelectasis'

Linear opacities at the left lung base represent atelectasis, unchanged. There is improved aeration at the right lung base. Heart size and mediastinal contours are stable. Right PICC line terminates at the superior cavoatrial junction.

chest x-ray; 'Consolidation'; 'Edema'

A portable upright chest radiograph demonstrates an endotracheal tube in the mid to lower thoracic trachea, left approach central line with the tip in the low SVC, and nasoenteric tube coursing below the diaphragm and off the inferior edge of the image. There has been interval resolution of a right pleural effusion. No pneumothorax is present. Mild pulmonary edema is greater on the right than left. Bibasilar consolidations could represent atelectasis, but a superimposed infectious process cannot be excluded. The visualized upper abdomen is unremarkable.

chest x-ray; 'Atelectasis'; 'Cardiomegaly'; 'Support Devices'

Unchanged position of the tracheostomy tube and the right central venous access line. Borderline size of the cardiac silhouette. Mild retrocardiac atelectasis. No pulmonary edema, no pneumonia, no pleural effusions.

chest x-ray; 'No Finding'; 'Support Devices'

The enteric tube courses below the diaphragm and terminates within the nondistended stomach in appropriate position. There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. The partially imaged abdomen is unremarkable.

chest x-ray; 'Pleural Effusion'; 'Support Devices'

There is a left IJ central venous line and a right subclavian central venous line which are unchanged in position. There is also a left-sided chest tube whose distal tip is at the lung apex. There is also a second chest tube on the left with the distal tip at the lung base. Since the previous study, there has been slight decrease in left-sided pleural effusion with some loculated fluid at the left mid lung field. The right lung is grossly clear. No pneumothoraces are identified.

chest x-ray; 'No Finding'

Compared to prior chest radiographs ___. Lungs fully expanded and clear. Heart size normal. No pleural abnormality.

chest x-ray; 'Atelectasis'; 'Cardiomegaly'; 'Fracture'; 'Lung Opacity'

AP single view of the chest has been obtained with patient in sitting semi-upright position. Comparison is made with the next preceding similar study of ___. As before, elongated and widened thoracic aorta with calcium deposits in the wall is encountered but appears unchanged. Cardiac enlargement with left ventricular prominence, compatible with the clinical history of longstanding hypertension. The pulmonary vasculature has not undergone any significant change during the latest examination interval. The scattered basal parenchymal densities interpreted as atelectasis - possible aspiration infiltrates have not changed significantly, and no new abnormalities are seen on this portable chest examination with the patient in semi-upright position. As before, there exists a marked right-sided scoliotic prominent curvature of the thoracic spine. There is evidence of multiple old rib fractures in the left hemithorax. No new acute abnormalities are identified.

chest x-ray; 'Atelectasis'

The cardiac, mediastinal and hilar contours are unchanged with heart size appearing mildly enlarged. Low lung volumes persists with crowding of bronchovascular structures but no overt pulmonary edema. Atelectasis in the lung bases persists. No focal consolidation, pleural effusion or pneumothorax is present. Cholecystectomy clips are demonstrated in the right upper quadrant of the abdomen. Contrast from recent CT exam is seen within the collecting systems bilaterally.

chest x-ray; 'Lung Opacity'; 'Support Devices'

In comparison with the earlier study of this day, there has been placement of a nasogastric tube that extends to the upper to mid portion of the stomach. The side-port is probably just distal to the esophagogastric junction. Diffuse pulmonary opacification persist bilaterally.

chest x-ray; 'Lung Opacity'

Near-complete opacification of the right hemithorax mildly increased with possible slight decrease in aeration as compared to the outside hospital chest radiograph from earlier today, ___. No real discrete aerated lung is currently seen on the right. There has been an been no decrease in the right-sided opacification. Persistent slight mediastinal shift to the left.

chest x-ray; 'Atelectasis'; 'Pleural Effusion'; 'Support Devices'

Comparison to ___. Stable position of the left pigtail catheter. Decrease in extent of the left pleural fluid collection. Decrease in severity of the pre-existing left basal areas of atelectasis. Stable appearance of the right lung and of the heart.

chest x-ray; 'Pleural Effusion'

As compared to previous study of earlier the same date, endotracheal tube and left chest tube have been removed, with no visible pneumothorax. Exam is otherwise remarkable for apparent increase in size of a layering right pleural effusion although positional differences may contribute to this apparent change.

chest x-ray; 'Atelectasis'; 'Cardiomegaly'; 'Lung Opacity'; 'Pleural Effusion'; 'Pneumonia'; 'Pneumothorax'; 'Support Devices'

As compared to the previous radiograph, the ___ of the known right pneumothorax are constant an unchanged. The right pleural drain is in unchanged position. The extent of the right pleural effusion and of the subsequent atelectasis at the right lung base are improved. Unchanged appearance of the left lung bases, with a relatively extensive parenchymal opacity, likely reflecting a combination of atelectasis and pneumonia. Mild cardiomegaly. Left Port-A-Cath is in unchanged position.

chest x-ray; 'Cardiomegaly'; 'Consolidation'; 'Edema'; 'Lung Opacity'

1. There is consolidative opacification in the right upper lobe and in the left lower lobe, which would be concerning for pneumonia or aspiration. In addition, there is likely airspace opacity within the right middle lobe as the right heart border is obscured. Findings are felt to less likely represent pulmonary edema. Clinical correlation, however, is advised. Radiopaque areas within the paratracheal soft tissues may represent calcified lymph nodes, although correlation with prior imaging would be helpful to better characterize this finding. The heart is upper limits of normal in size given portable technique. No pneumothorax is seen. Possible layering effusions, left greater than right.

chest x-ray; 'Pneumothorax'; 'Support Devices'

There has been interval removal of the right-sided pigtail catheter when compared to the prior exam. There is possibly a trace pneumothorax, but not substantial. Surgical sutures are seen projecting over the right hemithorax. There are no pleural effusions. No focal consolidations are seen. Heart size is normal and osseous structures are unchanged.

chest x-ray; 'Cardiomegaly'; 'Pleural Effusion'; 'Pneumothorax'; 'Support Devices'

Compared to chest radiographs since ___ most recently ___ through ___, read in conjunction with the chest CT performed ___. Residual consolidation or atelectasis at the right lung base has improved with evacuation of right pleural effusion, although the chest radiograph does not reflect the substantial the residual of from multiple loculations of right pleural effusion. The crescentic interface at the base of the right Lung should not be mistaken for pneumothorax it is right lower lobe extending anteriorly below a partially fluid-filled major fissure. Cardiomegaly is severe and pulmonary vasculature is engorged but there is no pulmonary edema. No pneumothorax. The right jugular line ends in the upper right atrium. Transvenous right atrial biventricular pacer defibrillator leads unchanged in their respective positions.

chest x-ray; 'Lung Opacity'; 'Support Devices'

In comparison with the study of ___, the patient has taken a slightly better inspiration and there is now a tracheostomy tube in place with the right IJ catheter removed. Cardiac silhouette is within normal limits. There is bilateral pulmonary opacifications, which could reflect non-cardiogenic vascular congestion or resolving ARDS. Some asymmetric increased opacification at the left base could reflect developing consolidation in the appropriate clinical setting, however, the opacifications from previous ARDS have consistently been more prominent on the left, so this may merely reflect the natural course of resolution.

chest x-ray; 'Cardiomegaly'; 'Lung Opacity'; 'Pleural Effusion'; 'Support Devices'

CHEST, SINGLE AP PORTABLE VIEW. Compared with ___ at 8:48 a.m. and allowing for differences in technique, I doubt significant interval change. Again seen is cardiomegaly, with increased retrocardiac density, and a small left effusion, with underlying collapse and/or consolidation. There may also be a small layering right effusion, with hazy opacity at the right base. There is upper zone redistribution and mild vascular plethora. Left IJ central line overlies mid SVC.

chest x-ray; 'Pneumothorax'; 'Support Devices'

A second nasogastric tube was placed, as compared to ___, 00:26. The tip projects over the proximal parts of the stomach. No complications, notably no pneumothorax. Otherwise unchanged radiograph.

chest x-ray; 'Atelectasis'; 'Pleural Effusion'; 'Support Devices'

Moderate bilateral pleural effusions have increased since ___. Cardiac silhouette normal size is unchanged, pericardial centesis catheter still in place. Upper lungs clear. Moderate left lower lobe atelectasis is likely due to left pleural effusion. Focal lesion right midlung, has involuted appreciably since ___, presumably focal infection or infarction. Left jugular line ends in the upper SVC. No pneumothorax.

chest x-ray; 'No Finding'; 'Support Devices'

The Dobbhoff tube is now positioned with tip in the stomach. Cardiomediastinal silhouette is normal. The hila are normal. The bilateral pulmonary vasculatures are normal. The lungs are clear. No pleural effusion. No pneumothorax. No fractures.

chest x-ray; 'Atelectasis'; 'Cardiomegaly'; 'Edema'; 'Lung Opacity'; 'Pleural Effusion'

As compared to the previous radiograph, the patient has been intubated. There is a massive newly appeared opacity at the level of the right upper lobe, suggesting the presence of a complete right upper lobe atelectasis. This is combined with an increasing amount of right pleural effusion so that large parts of the right hemithorax are completely opacified. The signs indicative of pulmonary edema in the left lung have minimally decreased. The heart appears to remain enlarged. No left-sided pneumothorax.

chest x-ray; 'Atelectasis'; 'Cardiomegaly'; 'Enlarged Cardiomediastinum'; 'Pleural Effusion'

Portable AP radiograph of the chest was reviewed in comparison to ___ and chest CT from ___. Radiograph was obtained after removal of the foreign body located in the upper esophagus. The heart size and mediastinum are grossly unchanged, but there is evidence of bibasilar areas of atelectasis. There is potentially small amount of pleural effusion present. Widening of the upper mediastinum is redemonstrated related most likely to the presence of the foreign body.

chest x-ray; 'Pneumonia'

There is worsening heterogeneous opacification of the right middle and right lower lobe concerning for worsening pneumonia or aspiration. There are small bilateral pleural effusions. There is no pneumothorax or overt pulmonary edema. Emphysema is noted. The heart is stable in size, and the patient is status post gastric pull through.

chest x-ray; 'Enlarged Cardiomediastinum'; 'Support Devices'

In comparison with the study of ___, the endotracheal tube remains somewhat close to the carina, though this may again reflect flexion of the neck of the patient. Central catheter remains in the upper SVC and the enteric tube extends well into the stomach. Cardiomediastinal silhouette is stable. There is increasing elevation of the left hemidiaphragmatic contour. No acute focal pneumonia or appreciable vascular congestion.

chest x-ray; 'Edema'; 'Lung Opacity'; 'Support Devices'

Since the prior study there has been progression of hilar enlargement and perihilar edema. Left lower lobe opacity appears to be more conspicuous most likely as part of the edema process. ET tube tip is 7 cm above the carinal. Right internal jugular line tip is at the level of superior SVC. NG tube tip is not clearly seen on current examination, most likely in the stomach. No pneumothorax.

chest x-ray; 'Cardiomegaly'; 'Edema'; 'Lung Opacity'; 'Pneumothorax'; 'Support Devices'

Right-sided chest tube is unchanged in position. A very small right apical pneumothorax is now visible. Diffuse subcutaneous emphysema and mild pneumomediastinum are unchanged. Cardiac silhouette remains enlarged and is accompanied by increasing pulmonary vascular congestion accompanied by mild perihilar edema. More confluent opacities at the bases could reflect dependent edema, but differential diagnosis includes aspiration, atelectasis, and evolving infection.

chest x-ray; 'Atelectasis'; 'Cardiomegaly'; 'Support Devices'

As compared to the previous radiograph, the lung volumes are slightly increased, likely reflecting improved ventilation or a stronger inspiratory effort. Atelectasis at the right lung bases and in the retrocardiac lung areas, however, persist. Coronary stent is better visualized than on the previous image. Unchanged left subclavian catheter. Borderline size of the cardiac silhouette without pulmonary edema.

chest x-ray; 'Atelectasis'; 'Lung Opacity'; 'Support Devices'

Support lines and tubes are unchanged in position. Cardiomediastinal silhouette is prominent but stable. There is mild improved aeration. There remains atelectasis at the lung bases and a left retrocardiac opacity. There are no pneumothoraces.

chest x-ray; 'Pleural Effusion'; 'Support Devices'

Right PICC line tip is at the level of lower SVC. Cardiomediastinal silhouette is unchanged. Right pleural effusion is moderate, unchanged. Mild vascular congestion is demonstrated but overall no substantial change since the previous examination has been demonstrated within the chest.

chest x-ray; 'Atelectasis'; 'Cardiomegaly'; 'Pleural Effusion'; 'Support Devices'

As compared to the previous radiograph, the monitoring and support devices, including the endotracheal tube, are unchanged. The tip of the endotracheal tube now projects approximately 7 cm above the carina and could be advanced slightly, by approximately 1 to 2 cm. Minimal blunting of the costophrenic sinus on the left suggests the presence of a small left pleural effusion, combined to a pre-existing retrocardiac atelectasis. No overt pulmonary edema. No pneumonia. Unchanged moderate cardiomegaly.

chest x-ray; 'Atelectasis'; 'Cardiomegaly'; 'Pleural Effusion'; 'Support Devices'

The uppermost of 2 right pleural drainage catheters remains sharply folded, which may account for persistence of the nearby loculated costal hemothorax. The lower tube is angulated, and could be fissural, which would, in turn explain persistence of the basal collection. A lateral view or chest CT scanning would be required to assess the location of the tubes with respect to the pleural fluid collections. Left lower lobe remains collapsed, and moderate left pleural effusion is still present. There is no pneumothorax on either side. Cardiac silhouette remains mildly enlarged. Mediastinum is unremarkable and unchanged. Cannula projecting over the right heart is unchanged in position. Tip of the ET tube is above the upper margin of the clavicles, no less than 7 cm from the carina and could be advanced 3 cm for more secure positioning. Swan-___ catheter ends in the pulmonary outflow tract. Feeding tube and esophageal drainage tube passes into the stomach and out of view. Right jugular line ends in the low SVC.

chest x-ray; 'Lung Opacity'; 'Support Devices'

In comparison with the earlier study of this date, there has been placement of an endotracheal tube with its tip approximately 6.5 cm above the carina. Nasogastric tube has been placed that extends well into the stomach. Extensive free intraperitoneal gas with bibasilar opacifications persist.

chest x-ray; 'No Finding'

As compared to chest radiograph from the same day, overall no substantial change of the right lung. Slight improvement in the left lung. ETT is 3 cm from the carina. The tip of the nasogastric tube in the stomach, partially beyond view of this chest radiograph. Mild pulmonary edema and moderate bilateral effusions unchanged. Persistent lower lobe opacities likely reflect atelectasis and effusions. No pneumothorax.

chest x-ray; 'Lung Opacity'; 'Pleural Effusion'; 'Support Devices'

Interval placement of an ECMO cannula via a right internal jugular approach and extending to the junction of the right atrium and inferior vena cava. No visible pneumothorax. Endotracheal tube and nasogastric tube remain in standard position. Widespread bilateral airspace opacities involving the left lung to a greater degree than the right have slightly progressed in the interval, and a moderate-sized left pleural effusion has also worsened.

chest x-ray; 'Atelectasis'; 'Lung Opacity'; 'Pleural Effusion'; 'Support Devices'

In comparison with the study of earlier in this date, the endotracheal to tip lies about 5.4 cm above the carina. Other monitoring and support devices are unchanged. No evidence of pneumothorax. Retrocardiac opacification is consistent with volume loss small left lower lobe and pleural effusion. Less prominent effusion and atelectasis on the right. Mild elevation of pulmonary venous pressure.

chest x-ray; 'Lung Lesion'; 'Support Devices'

A right chest tubes are in place. Heart size and mediastinum are stable. No appreciable pneumothorax or pleural effusion is noted. A right suprahilar mass is unchanged in appearance.

chest x-ray; 'No Finding'

The cardiac, mediastinal and hilar contours appear unchanged. Streaky right basilar opacification with volume loss suggests chronic atelectasis or scarring, also unchanged. There is potentially a small pleural effusion on the right, but no evidence for one on the left. There is no pneumothorax. As previously noted, the available AP view of the left shoulder suggests dislocation with possible healed or healing fractures suggested by irregular sclerosis along the margin of the glenoid.

chest x-ray; 'No Finding'

The lungs are clear. 4-mm right lower lobe nodule seen on recent CT is not visualized on this exam. The cardiomediastinal silhouette is unremarkable. The hilar contours are unremarkable. There are no pleural effusions or pneumothoraces seen. The bones are intact.

chest x-ray; 'Cardiomegaly'; 'Lung Opacity'

As compared to the previous radiograph, no relevant change is seen. Extensive bilateral basal parenchymal opacities, likely reflecting infected areas of bronchiectasis, as documented on the CT examination from ___. Moderate cardiomegaly without pulmonary edema. A minimal right pleural effusion could be present. No pneumothorax.

chest x-ray; 'Lung Opacity'; 'Pleural Other'

There has been interval removal of a left central venous line. ___ again overlie the right chest. There is slight decrease in opacity in the right mid chest with slight improvement of aeration of the right lung. Again seen is lateral pleural thickening along the staple line. Right greater than left biapical pleural thickening is seen. Cardiac and mediastinal silhouettes are stable. No pulmonary edema is seen.

chest x-ray; 'Cardiomegaly'; 'Pleural Effusion'; 'Support Devices'

Large right pleural effusion and moderate left effusion are grossly unchanged. Evaluation of cardiac size and vascular congestion is limited. ET tube is in standard position. NG tube tip is in the stomach. Right IJ catheter tip is in the right atrium

chest x-ray; 'Pleural Effusion'; 'Support Devices'

Position of left pleural catheter has slightly changed since recent study of earlier the same date, and note is made of slight increase in small to moderate left pleural effusion. No other relevant changes since the recent study.

chest x-ray; 'Consolidation'; 'Pleural Effusion'; 'Pneumonia'

AP radiograph of the chest demonstrates stable cardiomediastinal silhouette. No definitive pneumothorax is noted on the current study. Bilateral pleural effusions and bibasal consolidations are noted. Overall, no definitive focal consolidation which could be new and explain the patient's symptoms is demonstrated but bibasal or unibasal pneumonia is a possibility.

chest x-ray; 'Support Devices'

Since ___, a tracheostomy tube is been placed. A small amount of pneumomediastinum has developed following the procedure, but there is no visible pneumothorax. Lungs are clear except for minor atelectasis at the left base.