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andrejikica

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mimic_chest_xray_v_1_test

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

Comparison to ___. The left PICC line was removed. Newly placed right central venous access line. The tip projects over the cavoatrial junction. Minimal retrocardiac atelectasis. No pneumonia, no pulmonary edema, no pleural effusions.

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

Compared with the prior study, no change in the positioning of the endotracheal tube and right IJ central line. The NG tube terminates in the stomach. Left retrocardiac atelectasis has improved. There is a small persistent left basilar opacity. The right lung is better aerated. No evidence of pneumothorax.

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

Portable semi-upright radiograph of the chest demonstrates low lung volumes with resultant bronchovascular crowding. Two chest tubes project over the right hemithorax. There is a small right-sided pleural effusion with adjacent atelectasis. No pneumothorax. Right-sided Port-A-Cath is in unchanged position. The cardiomediastinal and hilar contours are unchanged. The left lung is essentially clear.

chest x-ray; 'Cardiomegaly'

Comparison to ___. No relevant change is noted. Borderline size of the cardiac silhouette. Stable right hilar prominence. Mild elongation of the descending aorta. Mild cardiomegaly. No pleural effusions. No pulmonary edema.

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

In comparison with the study of earlier in this date, the fixation devices remain in place. Continued prominence of the cardiac silhouette with the left hemidiaphragm now sharply seen and little if any retrocardiac opacification. No evidence of appreciable pneumothorax.

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

AP view of the chest. An enteric tube ends in the proximal jejunum. There is slight blunting of the right costophrenic angle which indicates a small right pleural effusion, decreased from prior study. No focal consolidation. Mild-to-moderate cardiomegaly is stable. No mediastinal or hilar contour abnormality. No pneumothorax. However, the lung apices are not imaged.

chest x-ray; 'No Finding'

AP single view of the chest has been obtained with patient in semi-upright position. Analysis is performed in direct comparison with a next preceding similar study of ___. The position of the ETT is unaltered and terminates some 4 cm above the level of the carina. A right-sided wide caliber sheath advanced via the internal jugular right approach remains in unchanged position. The same holds for a right-sided PICC line terminating in the mid portion of the SVC. A new NG tube is now seen reaching well below the diaphragm. Evidence of bilateral pleural effusion, slightly more on the right than the left appears unchanged. No pneumothorax on either side in the apical area.

chest x-ray; 'Atelectasis'

The metallic pattern along the mid portion of a left brachiocephalic and subclavian stent shows irregularity along the mid portion of the stent where it crosses over the left first rib. This is probably due to an impression on the stent by the rib, but appears new since the prior CT, which was performed very shortly after placement. The cardiac, mediastinal and hilar contours appear within normal limits. The lungs appear clear. There are no pleural effusions or pneumothorax. There is similar mild relative elevation of the right hemidiaphragm.

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

As compared to the previous radiograph, no relevant change is seen. Massive cardiomegaly. Moderate retrocardiac atelectasis that has newly appeared. Mild pulmonary edema. No larger pleural effusions. No evidence known of pneumonia in the well ventilated lung parenchyma.

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

As compared to the previous image, the malpositioned Dobbhoff catheter has been removed there currently is a correctly positioned orogastric tube in situ. The tip of the tube is not visualized on the image. But appears to be in the pre-pyloric position. All other monitoring and support devices are unchanged.

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

As compared to the previous radiograph, there is minimal increase in extent of the left pleural effusion. Otherwise, the radiograph is unchanged, unchanged monitoring and support devices.

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

Comparison is made to prior study from ___. Endotracheal tube, feeding tube, and right-sided subclavian catheter are unchanged in position. There are again seen very low lung volumes due to poor inspiratory effort. There is prominence of pulmonary vascular markings suggestive of a moderate pulmonary edema. No pneumothoraces are seen.

chest x-ray; 'Pleural Effusion'

There is a very large pleural effusion occupying much of the right hemithorax with mild leftward shift of mediastinal structures and inferred atelectasis of much of the right lung. A portion of the right upper lobe remains aerated, however. Patchy left basilar opacity suggests minor atelectasis. There is no definite pleural effusion on the left.

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

Severe cardiomegaly has worsened, accompanied by mild asymmetric pulmonary edema. There is substantially greater consolidation in the right lower lung while the right upper lung is relatively clear. Because of the discrepancy, this is more likely due to pneumonia than dependent edema. Severe left Left lower lobe consolidation has not changed appreciably since ___, either persistent pneumonia or lower lobe collapse. ET tube in standard placement. Right PIC line ends in close to the estimated location of the superior cavoatrial junction. Transvenous right atrial ventricular pacer leads are in standard placements respectively. No pneumothorax.

chest x-ray; 'No Finding'

In comparison with the study of ___, the patient has taken a better inspiration. No evidence of post procedure pneumothorax. No definite pleural effusion or acute focal pneumonia or pulmonary vascular congestion.

chest x-ray; 'Edema'

Compared with the prior study, mild cardiomegaly is unchanged. Mediastinal and hilar contours are unchanged. Increased diffuse interstitial lung markings suggest mild interstitial pulmonary edema. Intact median sternotomy wires and mediastinal clips again seen.

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

Comparison to ___. The monitoring and support devices are stable. Lung volumes continue to be low. Mild pulmonary edema is present. Moderate cardiomegaly. No larger pleural effusions. No focal parenchymal opacities suggesting pneumonia, with the exception of an atelectasis in the retrocardiac lung regions.

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

As compared to the previous radiograph, no relevant change is seen. Minimal atelectasis at the lung bases. No overt pulmonary edema. No pneumonia, no pleural effusions. The monitoring and support devices are constant.

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

Status post left wedge resection. The left chest tube is in situ. No relevant pneumothorax on the left. Severe overinflation of the stomach that should be relieved with a nasogastric tube. Mild bilateral areas of atelectasis at the lung bases, right more than left, no pulmonary edema. No pleural effusions.

chest x-ray; 'Lung Opacity'

A single frontal upright view of the chest was obtained portably. Lung volumes are slightly low resulting in bronchovascular crowding. Increased opacity at the left lung base may represent infection. There is no pleural effusion or pneumothorax. Heart size is normal. Mediastinal silhouette and hilar contours are normal. Free air under the right hemidiaphragm is likely related to peritoneal dialysis.

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

As compared to the previous radiograph, there is unchanged evidence of bilateral pleural effusions. The extent of the effusions, however, has slightly decreased. The subsequent areas of bilateral atelectasis are unchanged. The patient has no pneumothorax but the heart remains enlarged and there are signs of mild fluid overload. The left pectoral pacemaker is unchanged.

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

Shallow inspiration. Linear perihilar, bibasilar opacities, largely appearance of atelectasis. More prominent opacity left lower lobe medially behind the heart, atelectasis versus pneumonitis. Findings are new since prior exam. Tiny right pleural effusion or thickening. No pneumothorax.

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

In comparison with the study of ___, the monitoring and support devices remain in place. Continued consolidation in the left lung with probably a moderately decreased pulmonary edema. Opacification at the bases obscuring the hemidiaphragms is consistent with pleural effusion and compressive atelectasis at the bases. Substantial volume loss in the left lower lobe is identified.

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

Comparison is made with prior study performed the same day earlier in the morning. Cardiomegaly and widened mediastinum have improved. Mild pulmonary edema has improved. Right lower opacities, a combination of effusion and atelectasis, are grossly unchanged. The amount of bilateral pleural effusions is difficult to establish, probably improved from prior study. ET tube is in standard position. NG tube tip is out of view below the diaphragm. Surgical clips project in the upper abdomen.

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

AP chest compared to ___: No pneumothorax or appreciable right pleural effusion, ___ drainage tube still in place. Right subclavian catheter ends low in the SVC. Upper mediastinal drain in the midline. Moderate left pleural effusion and left lower lobe atelectasis are stable. Left upper lung clear. Very small amount of barium is retained in the neoesophagus following upper GI swallow. The vacuum bulb seen on yesterday's 4:32 a.m. chest radiograph is now positioned over the right upper abdominal quadrant.

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

In comparison to prior radiograph from earlier today, a left internal jugular catheter has been placed, terminating in the lower superior vena cava, with no visible pneumothorax. Multifocal areas of consolidation involving the right lung and left lower lobe have worsened and are concerning for evolving aspiration pneumonia. Small right pleural effusion has slightly increased in size.

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

NG tube tip is out of view below the diaphragm. Cardiomediastinal contours are normal. Minimal basilar atelectasis is unchanged from prior study performed six hours earlier. There is no pneumothorax or large effusion.

chest x-ray; 'Edema'

A right-sided PICC terminates in the mid SVC. The trachea is central. The cardiomediastinal contour is unchanged. There is persistent prominence of the bilateral upper lobe pulmonary vasculature with bilateral perihilar airspace opacities, the appearances are most consistent with pulmonary edema. No pleural effusion seen. No pneumothorax seen. Bilateral apical pleural scarring is symmetric. The visualized bony structures are unremarkable in appearance.

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

Compared to chest radiographs since ___, most recently ___:53. Tips of the left trans subclavian right atrial biventricular pacer leads are in standard placements. The courses of the right atrial right ventricular leads have changed and now have a more standard appearance. No pneumothorax pleural effusion or mediastinal widening. Mild cardiomegaly stable. Pulmonary vasculature is mildly engorged, but there is no pulmonary edema.

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

AP portable upright view of the chest. A right thoracostomy tube is present. A right pneumothorax is no longer appreciated. The left subclavian central venous catheter terminates at the mid SVC. The heart size remains normal. The hilar and mediastinal contours remain within normal limits.

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

AP chest compared to ___: Previous pulmonary edema has resolved. Severe cardiomegaly is less pronounced. Lung volumes are low and both bases are partially atelectatic, but this is improving. Upper lungs are clear. ET tube and right internal jugular line are in standard placements. A right subclavian line ends in the body of the right atrium. Nasogastric tube passes into the stomach and out of view. No pneumothorax. Pleural effusion is small on the left, if any.

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

AP radiograph of the chest was reviewed in comparison to ___. The PICC line tip terminates at the level of the axilla, most likely in the axillary vein. The heart size and mediastinum are stable in appearance. Linear atelectasis in the left lower lung is unchanged. There is no pleural effusion or pneumothorax.

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

Compared to chest radiographs ___ and ___. New subcutaneous emphysema in the right chest wall suggests right pneumothorax even though no definite pleural line is visible. It could be anterior. Right pleural drainage tube is more horizontal, another indication of pneumothorax or fissural positioning in the setting of worsening right basal atelectasis. Left lung is grossly clear. Heart size normal.

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

Comparison to ___. Minimal decrease in extent of the right pleural effusion. Stable position of the cardiac silhouette. Stable monitoring and support devices. Unchanged appearance

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

There is a large right-sided pneumothorax which has developed since the previous study. Endotracheal tube tip has been pulled back and is now 6 cm above the carina. The left side central venous line and nasogastric tube are appropriately positioned. Heart size is within normal limits. There are patchy diffuse airspace opacities throughout both lungs which appear stable.

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

The heart size is normal. The hilar and mediastinal contours are unremarkable. The NG tube is seen in appropriate position, in the distal stomach, well below the diaphragm. Again also seen is the 2.3-cm left lower lobe pulmonary nodule which is better evaluated on the prior CT. No other focal opacities are identified in the lung. The visualized osseous structures are unremarkable.

chest x-ray; 'No Finding'

A single portable frontal chest radiograph was obtained. Lung volumes are low. A large right paratracheal mass is grossly unchanged since ___. A mass in the right major fissure is similar. The moderate right pleural effusion is similar. Cardiomegaly is unchanged. There is no pneumoperitoneum.

chest x-ray; 'No Finding'

Lungs are clear. Cardiac silhouette is normal. There is no pleural effusion, pneumothorax, pulmonary edema or evidence of pneumonia. There is no free air. Surgical clips in the right upper quadrant suggest prior cholecystectomy.

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

Compared to prior chest radiographs, most recently ___. Mild cardiomegaly and borderline pulmonary vascular congestion are new, suggesting early cardiac decompensation. . Bibasilar opacification is probably atelectasis. I see no pulmonary edema or findings in the mid and upper lungs to suggest pneumonia. No appreciable pleural effusion. No pneumothorax.

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

As compared to the previous radiograph, the left pigtail catheter is in unchanged position. The extent of pleural fluid appears to have slightly decreased. Borderline size of the cardiac silhouette. The right chest tube has been removed. There is massive apical pulmonary emphysema, but no safe evidence of pneumothorax on the current image. Nasogastric tube and endotracheal tube are in constant position.

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

Lungs are low in volume and aside from slightly worsened mild left basal atelectasis, clear. Pleural effusions are small if any. Heart size is normal. Feeding tube tip projects over the region of the pylorus. No pneumothorax.

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

There has been worsening of the opacities throughout both lung fields. There are more confluent areas of consolidation at the right base and upper lobes since the prior study. Findings are concerning for infectious/inflammatory process. There are no pneumothoraces. The heart size and mediastinum are within normal limits.

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

Moderate to severe bilateral pulmonary opacification worsened from ___ through ___, transiently improved early on ___, has worsened again since ___:30 on ___. Moderate bilateral pleural effusions may be present, larger today. Overall findings, particularly date today variations suggests a large component of pulmonary edema responsible for the appearance of the lungs. Cardiomegaly is mild. Right jugular line ends in the upper right atrium. ET tube in standard placement. 2 esophageal tubes passes into the stomach and out of view. No pneumothorax.

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

Nasointestinal catheter with the tip within the stomach. Advancement is recommended so that the side port is below the gastroesophageal junction.

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

A left-sided PICC line tip crosses midline and is seen projecting over the right subclavian vein. There is no pneumothorax. Remaining support and monitoring devices are in unchanged position. Right moderate pleural effusion is unchanged. Diffuse increased bone density is stable.

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

In comparison with the study of ___, there again is enlargement of the cardiac silhouette with pulmonary vascular congestion. The hemidiaphragms are more sharply seen consistent with improving bilateral pleural effusions, though some of this could merely represent a more upright position of the patient. Suggestion of a more coalescent area of opacification at the left base. In the appropriate clinical setting, this could represent a superimposed pneumonia. ___, MD ___=___

chest x-ray; 'Pleural Effusion'

NG has been removed. ET tube is unchanged Right IJ catheter is unchanged, ending at the atriocaval junction. The Dobbhoff tube is folded in the lower esophageal portion, with tip ending in an upper esophageous The bibasilar plrural effusion persists, minimally reduced since prior CXR and more conspicuous at the right base Cardiomediastinal silhouette is normal.

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

Comparison is made with prior study performed 10 hours earlier. Large bilateral pleural effusions with adjacent atelectasis and mild pulmonary edema are unchanged. The left PICC tip is in the lower SVC. HD catheter has been removed.

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

Endotracheal tube remains in standard position. Although nasogastric tube terminates in the stomach, the side port is above the GE junction level, as communicated by phone to Dr. ___ at 1:15 p.m. on ___ at the time of discovery. Cardiomegaly is accompanied by improved interstitial edema and resolving asymmetrical left perihilar opacity which is probably due to asymmetrical edema. Moderate left pleural effusion and adjacent left lower lobe atelectasis or consolidation are unchanged. Worsening opacity at right lung base may reflect dependent edema accompanied by atelectasis and effusion.

chest x-ray; 'Pleural Effusion'

A moderate multiloculated left pleural effusion is unchanged. There is no focal consolidation, pulmonary edema, or pneumothorax. Low lung volumes cause bronchovascular crowding and bibasilar atelectasis. A right IJ central venous catheter terminates in the low SVC, unchanged.

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

As compared to the previous radiograph, there is no relevant change. The monitoring and support devices, including the nasogastric tube coiled in the stomach, are constant in position. Atelectasis at both lung bases is again noted. Moderate other lung parenchymal changes. Normal size of the cardiac silhouette. No pulmonary edema.

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

An AP upright view of the chest was provided. The lungs are hyperinflated with upper lobe lucency, compatible with known underlying emphysema. There is new opacity in the right lower lung, compatible with pneumonia. No large effusion or pneumothorax is seen. Cardiomediastinal silhouette is normal. Bony structures are intact.

chest x-ray; 'No Finding'

Lungs are fully expanded and clear. Cardiomediastinal and hilar silhouettes and pleural surfaces are normal.

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

Comparison is made with prior study, ___. Mild cardiomegaly is stable. Aside from improving left lower lobe atelectasis, the lungs are clear. Mediastinal lymphadenopathy is better seen in prior CT from ___. There is no pneumothorax or pleural effusion.

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

Comparison to ___. The left pleural pigtail catheter is in unchanged position. There is no evidence of pneumothorax. No left pleural effusion. Stable position of the right PICC line. No pneumonia, no pulmonary edema. Normal size of the heart. Minimal retrocardiac atelectasis.

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

In comparison with the study of ___, there is been placement of a nasogastric tube that extends at least to the lower body of the stomach where it crosses the inferior margin of the image. The patient has taken a somewhat better inspiration, though there again is enlargement of the cardiac silhouette with bilateral pulmonary opacities consistent with pulmonary edema. Probably little change in the pleural effusions and basilar atelectasis. The PICC line again terminates in the right atrium. The questioned narrowing of the lower cervical trachea is not definitely appreciated at this time. A CT of the trachea could be obtained if there are significant symptoms.

chest x-ray; 'No Finding'

AP upright portable chest radiograph is obtained. Lungs appear grossly clear bilaterally without definite signs of pneumonia or CHF. Heart size is top normal, though this may be due to technique. Mediastinal contour is normal with faint atherosclerotic calcification along the aortic knob. Bony structures are intact. No large effusion or pneumothorax is seen.

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

No definite pneumothorax following evacuation of most of the previous moderate left pleural effusion. A new pleural drainage catheter is folded at the left lung base. Atelectasis persists at in the left lower lobe. Right lung grossly clear. Cardiac silhouette mildly enlarged.

chest x-ray; 'No Finding'

Comparison is made to prior examination of ___. The heart is normal in size. The mediastinal and hilar contours are unremarkable. The pulmonary vasculature is normal. The lungs are clear. Sternal wires are identified. There are no pleural effusions.

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

Endotracheal tube terminates 4.3 cm above the carina. NG tube terminates below the diaphragm. Otherwise, no relevant change since the exam 2 hours prior.

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

Pacemaker leads are in unchanged positions. Right pleural effusion has minimally decreased in the interim. Right PICC line tip terminates at the level of cavoatrial junction. There is no appreciable pulmonary edema. There is minimal right apical pneumothorax unchanged as compared to previous examinations.

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

As compared to the previous radiograph, the monitoring and support devices are in constant position. The lung volumes have slightly decreased, leading to crowding of the vascular and bronchial structures, in particular at the right lung base. Borderline size of the cardiac silhouette. Known bilateral old rib fractures. The tip of the right PICC line projects more distally on today's examination, approximately at the level of the mid-to-lower SVC.

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

The nasogastric tube is coiled in the mid to upper body of the stomach. No evidence of acute cardiopulmonary disease.

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

Volume of small left apical pneumothorax unchanged since earlier in the day. Small left pleural effusion may have increased, and there is greater atelectasis at both lung bases. Tiny right apical pneumothorax is stable. Cardiomediastinal silhouette is unremarkable. Transvenous pacer leads in standard placements unchanged. Subcutaneous emphysema in the left chest wall has migrated, but the volume is unchanged. There is a greater angulation and some displacement of multiple left rib fractures in the mid and lower posterolateral left hemi thorax

chest x-ray; 'Consolidation'; 'Edema'; 'Pneumonia'; 'Support Devices'

AP radiograph of the chest was reviewed in comparison to ___. The ET tube tip is 5 cm above the carina. The NG tube tip passes below the diaphragm terminating in the stomach. The right PICC line tip is at the cavoatrial junction. Heart size and mediastinum are unchanged but widespread parenchymal consolidations have progressed in the interim concerning for progression of the parenchymal process with the highest concern being multifocal pneumonia. Some extent of interstitial edema is most likely present but the focal nature of the progression is in favor of infection or potentially ARDS.

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

In comparison with study of ___, the tip of the Dobbhoff tube is little changed. The degree of coiling within the stomach is somewhat less. Nevertheless, the tube has extended to slightly past the midline, before coiling upon itself. Lungs remain clear.

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

The lung volumes are noted to be decreased. The ET tube tip terminates 3 cm above the carina. Focal areas of increased density are seen within the right upper lobe, right middle lobe, and left lower lobe, and may be secondary to atelectasis versus aspiration. Bilateral pleural effusions are noted, left greater than right. There is stable, moderate to severe cardiomegaly. The mediastinum is somewhat widened, which may be secondary to both the projection and the patient position.

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

Compared to the prior film, the Swan-Ganz catheter and mediastinal drain have been removed. Again seen is sternotomy, with mild prominence the cardiomediastinal silhouette, unchanged. Also again seen is left lower lobe collapse and/or consolidation, similar to the prior film. Minimal atelectasis right base is also similar. There is upper zone redistribution, without overt CHF. Minimal blunting of left costophrenic angle is more pronounced on the current film.

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

In comparison with the study of ___, the monitoring and support devices are essentially unchanged. There is again prominence of the cardio mediastinal silhouette, though the degree of vascular congestion appears to have decreased. Streaks of atelectasis are seen at the left base.

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

When compared to prior, there has been slight interval improvement in the degree of pulmonary edema. Blunting of the lateral costophrenic angles suggests small bilateral effusions, likely decreased from prior. Streaky retrocardiac and right basilar opacities are likely atelectasis. Moderate enlargement of the cardiac silhouette is similar compared to prior. Atherosclerotic calcifications are noted in the aorta. Right chest wall tunneled venous catheter is noted as well surgical clips of the upper mediastinum on the left. No acute osseous abnormalities.

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

Portable upright radiograph of the chest demonstrates a focal consolidation in the left lower lung that is new since the prior radiograph from ___ and corresponds to opacity recently seen on prior chest CT from ___, and is suspicious for pneumonia. There is no pleural effusion, pulmonary edema or pneumothorax. A large hiatal hernia is again seen. Bilateral lung nodules are better characterized on recent prior CT of the chest.

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

As compared to the previous radiograph, the patient has received a tracheostomy tube. The tip of the tube is in correct position and no evidence of pneumothorax. Minimal positional blunting of the left diaphragmatic contour. Right PICC line is in unchanged position. No nasogastric tube is seen. No pneumonia, no pulmonary edema, no pneumothorax.

chest x-ray; 'Atelectasis'; 'Pneumonia'

Single portable view of the chest. Oxygenation device projects over the right lung apex. There is mild interstitial edema. Retrocardiac opacity may be in part due to technique with possible underlying atelectasis or consolidation. Elsewhere the lungs are clear of focal consolidation. Cardiomediastinal silhouette is within normal limits for technique. Dense atherosclerotic calcifications seen at the aortic arch. No acute osseous abnormality is detected.

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

In comparison with the study of ___, the tracheostomy tube and nasogastric tube are in unchanged position. Continued substantial enlargement of the cardiac silhouette with pulmonary vascular congestion, bilateral pleural effusions, and volume loss in the lower lobes. In the appropriate clinical setting superimposed pneumonia of would have to be considered.

chest x-ray; 'Cardiomegaly'

Lungs are well expanded and essentially clear. Cardiomegaly is moderate to severe, but pulmonary vasculature is minimally engorged and there is no edema or appreciable pleural effusion.

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

As compared to the previous radiograph, there is no relevant change with the exception of slightly increasing left pleural effusion and a subsequent left basal atelectasis. No evidence of pneumothorax. The monitoring and support devices as well as the surgical stabilization devices are in constant position.

chest x-ray; 'No Finding'

Lungs are well-expanded and clear. Cardiomediastinal and hilar contours are unremarkable. No pneumothorax, consolidation, or pleural effusion.

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

Indwelling support and monitoring devices remain in standard position. Lung volumes are extremely low, accentuating cardiac silhouette and bronchovascular structures. Apparent worsening lower lung pleural and parenchymal opacities may at least in part be due to differences in lung volumes. Similarly, apparent worsening vascular engorgement could be due to accentuation by low volumes. With this in mind, repeat radiograph performed at a higher lung volume setting would be helpful for more direct comparison to previous exams.

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

As compared to the previous radiograph, the patient has received a nasogastric tube. The course of the tube is unremarkable, the tip of the tube projects over the middle parts of the stomach. No evidence of complications, no pneumothorax. Unchanged normal size of the cardiac silhouette. Normal alignment of sternal wires of the CABG.

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

Right-sided vascular stents are again noted. There is a right basilar opacity likely representing moderate right pleural effusion which is new since ___. Cardiomegaly appears stable. The mediastinum is widened likely due to portable AP technique. Patchy opacity in the right upper lobe may represent consolidation or loculated fluid. Linear opacities in the left lung most likely represent atelectasis. There are coils in the upper abdomen. No acute osseous abnormality identified.

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

Bibasilar consolidation is new since ___. There is no good evidence for volume loss. The interval is sufficient for the development of the aspirated pneumonia which is the presumptive diagnosis. Right hilar enlargement could be due to adenopathy, vascular engorgement or even acute pulmonary embolus. Previous pulmonary vascular and mediastinal venous engorgement has improved, and heart size is normal. ET tube and right internal jugular line and esophageal drainage tube are in standard placements respectively. Upper esophageal temperature probe in place.

chest x-ray; 'Cardiomegaly'

There has been interval endotracheal intubation. The endotracheal tube terminates about 4.5 cm above the carina. A pacemaker lead again terminates in the right ventricle. The heart is again enlarged. Calcification is noted along the left apical cardiac margins, as before. The mediastinal and hilar contours appear stable. The lungs appear clear. There are no pleural effusions or pneumothorax.

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

There has been interval placement of a right Pleurx catheter with the tip at the right lung base with interval decrease in right pleural effusion and no evidence of pneumothorax. Associated right lung base opacity is unchanged. There has been interval increase of asymmetric left perihilar and basal opacities suggestive of asymmetric edema. Cardiac silhouette remains stable.

chest x-ray; 'No Finding'

In comparison with study of ___, there is little overall change. Again there are low lung volumes without evidence of acute pneumonia, vascular congestion, or pleural effusion.

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

The new right PICC tip projects in the proximal right atrium, 7.8 cm below the carina. It should be withdrawn approximately 2-2.5 cm for optimal placement. Tracheostomy tube and left subclavian catheter tip are unchanged in position. The large layering left pleural effusion with adjacent atelectasis and right lower lobe atelectasis are unchanged from the prior study. There is probably a small right pleural effusion. The heart appears mildly enlarged. No new focal consolidation or pneumothorax detected.

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

Known small left pneumothorax is not clearly identified. Small left effusion with adjacent atelectasis has markedly increased. There are low lung volumes. Cardiac size cannot be evaluated.

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

Left pleural catheter is unchanged in position. Endobronchial valves is unchanged in position in the left hilum. No pneumothorax is seen. Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion.

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

Unchanged evidence of bilateral parenchymal opacities. Severity of the opacities has not substantially changed. Unchanged moderate cardiomegaly. Larger effusions are unlikely. The monitoring and support devices as well as the left pectoral pacemaker are constant in appearance.

chest x-ray; 'Atelectasis'; 'Enlarged Cardiomediastinum'; 'Lung Opacity'; 'Pneumonia'; 'Support Devices'

In comparison with the earlier study of this date, there is little change in the appearance of the left chest tube with no evidence of pneumothorax. Dobhoff tube again extends to the upper to mid stomach. Continued opacification at the right base is consistent with substantial volume loss in the right lower lobe and probable pleural fluid. However in the appropriate clinical setting, superimposed pneumonia would have to be seriously considered, especially in view of the suggestion of an area of consolidation above the hemidiaphragmatic contour. Mild atelectatic changes are seen at the left base..

chest x-ray; 'Edema'

The patient is status post sternotomy. The heart appears mildly enlarged. The pulmonary vasculature shows diffuse moderate prominence with ill definition to vascular margins suggesting pulmonary edema. There is no pleural effusion or pneumothorax.

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

Volume of bilateral pneumothorax can be underestimated due to semi supine positioning. It is at least small, left greater than right, but has not changed over the past several days. Left upper thoracostomy tube is in stable position, but there has been some redistribution of subcutaneous emphysema in the left chest wall. I do not see a drain on the right. Pneumomediastinum has not worsened over the past several days. Heart is normal size. Moderately extensive heterogeneous opacification has been stable in both lungs over the past 4 days having developed since the initial intake chest CT on ___ when the only lung abnormalities were mild contusion in the right lower lobe and left upper lobe collapse that subsequently cleared. Current findings therefore suggest pneumonia, with either pneumatoceles or cavities. ET tube and right subclavian line are in standard placements and a esophageal drainage tube passes into the stomach and out of view.

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

In comparison with the study of ___, there are lower lung volumes. Continued substantial enlargement of the cardiac silhouette with diffuse bilateral pulmonary opacifications most likely reflecting pulmonary edema. Bilateral pleural effusions with compressive atelectasis at the bases. The left subclavian catheter has been pushed forward. The tip appears to lie against the outer aspect of the superior vena cava and the catheter has not made a downward turn.

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

In comparison with the study of ___, there is continued increased opacification at the left base, most likely reflecting a combination of atelectasis and effusion. In the appropriate clinical setting, supervening pneumonia would have to be considered. Streaks of atelectasis are seen at the right base. Monitoring and support devices are essentially unchanged.

chest x-ray; 'Cardiomegaly'; 'Edema'; 'Pneumonia'

Moderate, with no focal consolidation to suggest infectious process. There is no appreciable pleural effusion and there is no pneumothorax. Cardiomegaly and mediastinal widening are unchanged but there is interval development of pulmonary edema,

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

AP radiograph of the chest was reviewed in comparison to ___. The NG tube tip is in the stomach. The ET tube tip is 4 cm above the carina. Bibasilar atelectasis is noted bilaterally. No pneumothorax is seen. Pleural effusions cannot be excluded.

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

Comparison is made with prior study ___. Mild cardiomegaly is stable. Extensive bilateral diffuse lung opacities have improved on the right lower lobe. There are no new lung abnormalities or pneumothorax. If any, there is a small right effusion. There are low lung volumes. Patient has been extubated.

chest x-ray; 'Pleural Effusion'

Heart size and mediastinum are stable. Bilateral pleural effusions are present, left more than right. There is no pulmonary edema. There is no pneumothorax.

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

A right chest wall Port-A-Cath terminates in the lower SVC. Left-sided pacemaker with single lead is seen in the right ventricle. Hepatobiliary stents are seen below the diaphragm. As compared to prior chest radiograph from ___, there has been interval placement of a right-sided chest tube which enters the right lateral chest wall and terminates in the right apical region. There is evidence of a small hydropneumothorax on the right with interval decrease of right-sided pleural effusion. There is some bronchovascular crowding and atelectasis at the left lower lobe. Surgical sutures are seen in the left lower lobe. The heart and mediastinal contours are within normal limits.

chest x-ray; 'Pneumonia'

Mild cardiomegaly is stable. The mediastinal and hilar contours are normal. Central pulmonary vasculature congestion is not significantly changed. Retrocardiac opacity with air bronchograms is not significantly changed. Left effusion is tiny. No pneumothorax. Lines and tubes: The ETT tip is approximately 5.4 cm above the carina. A left IJ venous line tip is in the upper SVC. Orogastric tube passes into the stomach and extends out of view.

chest x-ray; 'Pleural Effusion'

Lung volumes are low. There is an appearance of an elevated right hemidiaphragm with with relatively lateral peaking of the expected diaphragm suggesting subpulmonic effusion. The left lung is grossly clear. There is no visualized pneumothorax. Cardiomediastinal silhouette is within normal limits. No displaced fractures identified on this portable film.