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A nasogastric tube terminates in the stomach. The lung volumes are low. The cardiac, mediastinal and hilar contours appear unchanged. There is similar heterogeneous opacification of each lung, greater on the right than left, with indistinct pulmonary vasculature suggesting mild to moderate pulmonary edema the main difference is an increasing pleural effusion on the right with right basilar volume loss suggesting coinciding atelectasis. A small pleural effusion is noted on the left.
As compared to prior chest x-ray, there are no interval changes. Lung volume is still low with persistent right lung opacification, consistent with combination of consolidation and pleural effusion and compatible with pneumonia. Unchanged left base opacity is likely atelectasis. Left subclavian PICC is also unchanged with tip ending in mid SVC.
Heart size is normal. Widening of the mediastinum is most likely related to the very expiratory nature of the radiograph. No discrete consolidations demonstrated. No appreciable pleural effusion or pneumothorax seen. Repeated radiograph with emphasis on full inspiration is recommended
AP portable supine view of the chest. Endotracheal tube is seen with its tip located 2.8 cm above the carinal. A right IJ central venous catheter tip is positioned in the region of the low SVC. Lung volumes are low limiting assessment. No large consolidation or supine evidence for effusion or pneumothorax. Mediastinal contour is difficult to assess due to rotation. Bony structures are grossly intact. Degenerative changes are partially noted in the lumbar spine.
Compared to exam performed 6 hours prior, there is mild improvement of the right interstitial opacities, possibly due to better aeration. There is increased volume loss on the left with elevation of left hemidiaphragm and leftward mediastinal shift, likely due to lower lobe collapse and small amount of pleural fluid. The heart size is mildly enlarged. ETT terminates approximately 3.3 cm from the carina. There is no significant change in monitoring and support devices.
ET tube has been placed with the tip at 6 cm from carina. It can be moved down of 2 cm. Dobhoff tube position is unchanged and in standard position Right subclavian PICC is unchanged and in standard position with tip ending in the upper SVC Lung volume persists reduced, especially on the right lung for elevation of hemi diaphragm The heart size still mildly enlarged, with aorta elongated and calcification of the aortic arch.
Cardiac size is enlarged as before. Pacer leads are in standard position. . The lungs are clear. There is no pneumothorax or pleural effusion.
As seen on the prior CT there is consolidation in the right upper lobe. Increased opacity at the right lung base likely reflect a combination of pleural effusion and atelectasis. Left lower lobe atelectasis and a small left pleural effusion also noted. No new areas of consolidation seen. No pneumothorax seen.
As compared to the previous radiograph, there is no relevant change. A pseudocavitary lesion in the right lower lobe can no longer be seen with confidence. However, relatively extensive bilateral parenchymal opacities, likely reflecting a combination of edema and pneumonia, still present. Moderate cardiomegaly. No larger pleural effusions. Unchanged monitoring and support devices.
The cardiac, mediastinal and hilar contours appear stable. There is no pleural effusion or pneumothorax. The lungs appear clear.
Supine portable AP view the chest provided. Endotracheal tube is seen with its tip residing 4.9 cm above the carinal. An NG tube courses into the left upper quadrant. There is right basal atelectasis and possible tiny right pleural effusion. There is retrocardiac opacity which could reflect the presence of left lower lobe consolidation and possible effusion. There is no supine evidence for pneumothorax. Cardiomediastinal silhouette appears grossly within normal limits. Bony structures are intact.
There right upper lobe paramediastinal mass is again noted with subsequent volume loss in the right hemi thorax and superior elevation of right hilum. Thickening of the right paratracheal stripe is compatible with known adenopathy. There is no new consolidation nor effusion. Cardiac silhouette is within normal limits. No acute osseous abnormalities.
Heart size is normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is seen.
Support lines and tubing are unchanged in position when compared to the prior study. Catheter tubing projecting over the left heart border is presumed to represent a pericardial drain. Lung volumes are unchanged compared to the prior study with persistent left lower lobe atelectasis. Mild prominence of the pulmonary vasculature with haziness of the upper lobe pulmonary vessels consistent with a mild degree of congestive heart failure. No pneumothorax seen. A hazy airspace opacity in the left lower lung is similar when compared to the prior study and likely represents atelectasis.
Small left pleural effusion is new. Mild left basal atelectasis has increased. Heart size probably normal, exaggerated by pleural thickening or juxta mediastinal pleural effusion obscuring the right cardiac border.
As compared to previous radiograph from less than 2 hr earlier, there has not been a substantial change in the appearance of the chest except for slight improved aeration at the lung bases.
Unchanged bibasilar atelectasis.
No focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. No pulmonary edema is seen.
Normal heart size, mediastinal and hilar contours. Minimal patchy opacity at the left lung base could reflect atelectasis or aspiration. . No focal consolidation, pleural effusion or pneumothorax.
AP chest reviewed in the absence of prior chest radiographs: Lung volumes are quite low, obscuring some of the right lower lobe which is probably atelectatic. The upper lungs are clear and pleural effusions small if any. The heart is not enlarged. No pneumothorax.
As compared to the previous radiograph, the patient remains intubated and a nasogastric tube is seen. The right PICC line is in unchanged position. In the interval, the pre-existing parenchymal opacities, caused by a combination of pleural effusions and atelectasis, have decreased in severity in extent. The cardiac silhouette has also minimally decreased in size. No new opacities. No pneumothorax.
No previous images are available, so that comparison cannot be made with previous studies. There is enlargement of the cardiac silhouette with indistinctness of engorged pulmonary vessels consistent with pulmonary vascular congestion. Some hazy opacification at the bases could reflect layering effusion, though it could also be a manifestation of the size of the patient and resulting scattered radiation. Right IJ catheter tip extends to lower portion of the SVC.
AP portable upright view of the chest. Cardiomegaly is noted with mild pulmonary edema. No large effusion or pneumothorax is seen. A single lead pacemaker is seen extending into the right ventricle. The mediastinal contour is grossly unremarkable. The bony structures are intact.
Left lower lobe collapse is new, accompanied by small left pleural effusion. Less severe atelectasis at the right lung base is also increased. Low lung volumes exaggerate heart size which is probably only mildly enlarged. Mediastinal veins are still engorged but there is no edema. Left PIC line ends in the low SVC. Feeding tube passes below the diaphragm and out of view
AP portable supine view of the chest. Evaluation is limited due to overpenetrated technique. The endotracheal tube has been intervally advanced, with its tip now residing approximately 2 cm above the carinal. An NG tube is seen coursing inferiorly into the left upper abdomen though the tip is excluded from view. Further evaluation is not possible given technical limitations.
There is a moderate left effusion has increased compared to the prior study. The right-sided central line with tip in the right atrium is unchanged. There has been some interval improved aeration of right lower lobe and left mid lung.
Interval removal of right pigtail catheter. Doubt but cannot entirely exclude a tiny right apical pneumothorax. Otherwise, I doubt significant interval change.
There has been interval repair of the left-sided diaphragmatic rupture. There has been interval re-expansion of the left lung. The left lung is clear. There has appears to be interval increase in opacification of the right lung, likely secondary to pulmonary edema and pulmonary vascular congestion. There is no pneumothorax. There are no definite pleural effusions. Heart size is normal. ET tube terminates 2.7 cm above the carina. The bilateral chest tubes are in place. There seems to be an NG tube coiled in the upper esophagus. There are opacifications in the left subdiaphragmatic area, likely secondary to drains, however a foreign body cannot be ruled out.
Portable AP upright view of the chest provided. There may be mild pulmonary edema, though there is asymmetric opacity in the right lower lung which could reflect a superimposed pneumonia. There is a small right pleural effusion. Upper lungs appear well aerated. The heart and mediastinal contours are stable. Bony structures are intact.
As compared to the previous radiograph, the patient has received a left pectoral ICD. The leads are in expected position. There currently is no evidence of pneumothorax. Moderate cardiomegaly without overt pulmonary edema. No pleural effusions.
Portable frontal chest radiograph was obtained. Lungs are fully expanded and clear. The cardiomediastinal silhouette, hilar contours, and pleural surfaces are normal. There is no pleural effusion or pneumothorax.
As compared to the previous radiograph, the monitoring and support devices are constant. The extent of the right pleural effusion has minimally decreased. Otherwise, the radiograph is unchanged, with minimally improved ventilation at the left lung bases. No other relevant changes. No new parenchymal opacities. No pulmonary edema. No pneumothorax.
As compared to the previous radiograph, the vertebral stabilization devices are in unchanged position. In the interval, the nasogastric tube has been removed. The right PICC line is in unchanged position. There is resolving atelectasis at both the right and left lung bases. The cardiac silhouette remains at the upper range of normal. There is no overt pulmonary edema. No pneumothorax is noted.
No change as compared to the previous image. The lung volumes are low, but there is no evidence of pulmonary edema or pneumonia. No pleural effusions. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures.
Low lung volumes exaggerate the bronchovascular markings, but there is still increase in the markings from prior studies compatible with mild pulmonary edema. There is no evidence of pneumonia or pleural effusion. Central line has been removed. Cardiac size remains stable.
In the interval since the most recent prior examination, there has been placement of right IJ catheter with tip terminating approximately 2.3 cm below the cavoatrial junction. The patient is minimally rotated compared to the most recent prior examination with cardiomegaly and slightly increased pulmonary vascular engorgement. Bibasilar atelectases are again noted. There is fluid within the minor fissure.
As compared to the previous radiograph, the position of the monitoring and support devices is constant. The lung volumes remain low despite intubation. The atelectasis at the right lung base is slightly increasing in the extent. Otherwise, the radiograph is unchanged. Unchanged size of the cardiac silhouette.
As compared to the previous radiograph, the lung volumes have decreased. There is a focal area of parenchymal opacity at the right lung base, likely reflecting atelectasis, but coexisting pneumonia cannot be excluded. An area of consolidated lung in the retrocardiac lung region is not substantially changed. Moderate cardiomegaly persists. No larger pleural effusion. The monitoring and support devices are constant.
1. Nasogastric tube is again seen coursing below the diaphragm with the tip not identified. Endotracheal tube has its tip at the thoracic inlet. A left chest tube remains in place. A left subclavian central line continues to terminate in the proximal SVC. There is persistent triangular opacity at the right base likely reflecting atelectasis or pulmonary contusion. There is increasing consolidation in the retrocardiac region, also likely reflecting atelectasis, although pneumonia cannot be entirely excluded. There is a layering left effusion. No evidence of pulmonary edema. Heart remains stably enlarged. Aorta is somewhat unfolded and tortuous. No pneumothorax is appreciated.
The lungs are clear. No focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The heart is top-normal in size, overall unchanged.
Portable semi-upright radiograph of the chest demonstrates slight retrocardiac opacity consistent with atelectasis. There has been marked interval improvement in bilateral interstitial opacities consistent with improving pulmonary edema. The mediastinum remains widened, although has decreased slightly in size as compared to the prior. The heart is mildly enlarged. There is no pneumothorax. A chest tube projects over the right hemithorax. There is a stent in the decending thoracic aorta.
Status post removal of endotracheal tube and nasogastric tube. Stable cardiomegaly but worsening pulmonary edema with combined alveolar and interstitial features. Bilateral small-to-moderate pleural effusions are probably unchanged allowing for positional differences of the patient.
Asymmetric density is again demonstrated at the right lung base. The heart and mediastinal structures are unchanged. An endotracheal tube is been inserted and terminates at the thoracic inlet. A nasogastric tube is been placed and terminates in the region of the stomach.
One portable AP semi-erect view of the chest. A right internal jugular central venous catheter ends at the cavoatrial junction. NG tube ends in the stomach with last side port below the GE junction. Endotracheal tube ends 5 cm from the carina. Cardiomegaly is stable. Mediastinal and hilar contours are stable. Moderate pulmonary edema is unchanged.
A bedside AP radiograph of the chest demonstrates stable low lung volumes as well as marked bilateral lower lobe atelectasis. Although there are persistent findings consistent with hypervolemia, such as marked dilation of the azygos vein, the mild interstitial pulmonary edema seen on the prior radiograph has improved somewhat. Clearance of the edema has revealed heterogeneous opacities in the left upper lobe which may also be due to atelectasis, however, other causes such as underlying pneumonia cannot be excluded. There is possibly a small effusion on the left, if any. There is no pneumothorax. Moderate cardiomegaly persists. An endotracheal tube terminates no less than 4.5 cm above the carina. An orogastric tube terminates in the stomach.
The heart remains mildly enlarged. Severe mitral annular calcifications are again seen. The aorta is calcified and mildly tortuous. Mild to moderate pulmonary edema is markedly improved compared to the prior exam. Small bilateral pleural effusions persist. No pneumothorax is identified. There are no acute osseous abnormalities.
A bedside AP radiograph of the chest demonstrates clear lungs and normal hilar and cardiomediastinal contours. There is no pneumothorax or pleural effusion. Pulmonary vascularity is normal.
AP chest compared to 3:20 p.m.: The previously coiled nasogastric tube has been reinserted passing through the esophagus and into the stomach and out of view. Left subclavian line tip is at the junction of brachiocephalic veins. Moderate cardiomegaly has increased, due in part to lower lung volumes also exaggerating the extent of pulmonary vascular engorgement. Small left pleural effusion is stable. No pneumothorax. ET tube in standard placement.
The ET tube and right IJ line and NG tube are unchanged. There is a small left effusion, decreased in size compared to prior. This dense retrocardiac opacity consistent with volume loss/infiltrate/effusion.
Single portable supine frontal chest radiograph demonstrates moderately well-expanded lungs with mild right lower lobe atelectasis. Mild right lower lobe bronchial wall thickening with associated bronchiectasis is noted No pleural effusion, although slightly limited evaluation of the left costophrenic angle. No additional focal opacity. No pneumothorax. Heart size, mediastinal contour are, and hila are unremarkable.
1) Prominence of the cardiac silhouette likely related to technique. No acute pulmonary process identified. 2) Slight assymetry of sternoclavicular joints.
AP portable upright view of the chest. The heart size is normal. The hilar mediastinal contour or is are within normal limits. There is no mild prominence of the central pulmonary vessels, without overt edema. There is no pneumothorax, focal consolidation, or pleural effusion.
A new small caliber chest tube has been placed, terminating at the right lung apex. A right-sided pneumothorax is dramatically smaller and perhaps fully resolved, although potentially with trace lucency near the tip of the tube. The right lung is reexpanded with mild residual atelectasis of the right upper lobe. Mediastinal shift has resolved. The left lung remains clear.
A portable frontal chest radiograph again demonstrates a normal cardiomediastinal silhouette and slightly lower lung volumes compared to the day prior. Bilateral lower lung opacities are persistent, more confluent on the right and unchanged on the left. There is no appreciable pleural effusion or pneumothorax.
Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion. Right port-a cath tip is in the lower SVC
As compared to the previous radiograph, no relevant change is seen. The tip of the endotracheal tube projects 4.6 cm above the carinal. The course of the nasogastric tube is unchanged. No change in appearance of the lung parenchyma and the size of the cardiac silhouette. No evidence of pneumonia, no pleural effusions.
As compared to the previous radiograph, there is improved ventilation at the left and right lung bases, as reflected by increase radiolucency at both lung bases. However, the pre-existing parenchymal opacities on both the left and the right remain clearly visible. Moderate cardiomegaly. Unchanged position and course of the right internal jugular vein catheter.
Single portable view of the chest shows mildly low lung volumes, accentuating the cardiopulmonary contours. Tiny clips project over the left lung base. The lungs are clear. Hilar and mediastinal contours are normal. No pleural abnormality is seen. Of note, right chest wall port is unchanged with the catheter tip terminating at the cavoatrial junction.
Single semi-erect frontal view of the chest was obtained. The right lung is clear. Patchy left base opacity most likely represents atelectasis, though underlying aspiration is not entirely excluded. No pleural effusion or pneumothorax is seen. No pulmonary edema is seen. The cardiac silhouette is top normal. The aorta is calcified and tortuous.
Re- demonstrated is a tracheostomy in unchanged location overlying the upper midline mediastinum near the thoracic inlet, unchanged in appearance since prior. A right sided vascular stent is unchanged in appearance and orientation. Right hilar mediastinal clips are unchanged. The cardiomediastinal silhouettes are stable. Known left hilar mass is not well appreciated on the current study. The right hilum is unremarkable. There is no focal lung consolidation. There is no pulmonary vascular congestion. There is no pneumothorax or pleural effusion.
Portable frontal chest radiograph is slightly rotated to the left. There is no focal consolidation, pleural effusion, or pneumothorax. The cardiomediastinal silhouette is normal.
Radiograph centered at thoracoabdominal junction was obtained for assessment of nasogastric tube which terminates within the stomach.
Left pleural effusion has resolved following insertion of a basal pigtail pleural drainage catheter. There is no left pneumothorax. Moderate right pleural effusion stable. Previous mild pulmonary edema has improved although pulmonary vasculature is still engorged. Postoperative enlargement of the cardiomediastinal silhouette is stable. No pneumothorax. Right jugular introducer ends in the upper SVC. Feeding tube ends in the stomach
As compared to the previous radiograph, there has been resolution of a pre-existing right lower lobe parenchymal opacity. The lung volumes remain low, but there is no new parenchymal opacity. Moderate cardiomegaly without evidence of pulmonary edema. No pleural effusions. Normal appearance of the mediastinum.
As compared to the previous radiograph, a pre-existing opacity at the right lung base has completely resolved. On the left, the small pleural drain is seen in unchanged manner. Mild elevation of the right hemidiaphragm persists. Partial left lower lobe atelectasis. No pneumothorax.
Low lung volumes exaggerate the cardiomediastinal structures, which are otherwise unremarkable. No focal consolidations concerning for pneumonia are identified. There is no pleural effusion or pneumothorax. The visualized osseous structures are unremarkable.
Heart size and mediastinum are stable. Left chest tube is in place. ET tube tip is 6.5 cm above the carina.
Portable AP radiograph of the chest was reviewed with no prior studies available for comparison. The patient is after median sternotomy and CABG. Heart size and mediastinum are normal in size. Lung volumes are preserved. No definitive focal consolidations are demonstrated, but multiple rib fractures may obscure on the right presence of parenchymal abnormalities. Left lung is essentially clear and there is no appreciable pleural effusion or pneumothorax.
No focal consolidation is seen. There is minimal left base atelectasis. There is no large pleural effusion or pneumothorax. Cardiac and mediastinal silhouettes are unremarkable.
Right PICC line tip is at the level of lower SVC. There is interval extensive involvement of parenchymal opacities in particular on the right concerning for progression of pulmonary edema and multifocal consolidations. Tracheostomy is in place. Bilateral effusions, right more than left. The large.
As compared to the previous image, the patient has received a left pectoral pacemaker. The leads are in correct position. Mild fluid overload but no overt pulmonary edema. Moderate cardiomegaly. No pneumothorax. No pleural effusions.
Prior right-sided central venous catheter is no longer visualized. No large effusion identified noting resolution of prior moderate left-sided pleural effusion. Streaky retrocardiac opacity is most likely atelectasis. Superiorly, lungs are clear. Cardiomediastinal silhouette is within normal limits. Median sternotomy wires are intact. No acute osseous abnormalities.
Multifocal regions of consolidation are noted, most extensive in the left lower lung and in the retrocardiac region. Less conspicuous right perihilar opacities are also seen. Findings are compatible with pneumonia in the proper clinical setting. There is no large effusion or pneumothorax. Cardiomediastinal silhouette is within normal limits. Atherosclerotic calcifications noted at the aortic arch. No acute osseous abnormalities.
As compared to the previous radiograph, the right chest tube has been removed. The right lung is substantially better inflated than on the previous examination. There is no visible thorax on the current image. The left lung continues to be unremarkable, with the exception of minimal retrocardiac atelectasis. Borderline size of the cardiac silhouette. The right soft tissues show an AA inclusion at the site of tube insertion.
No previous images. No definite evidence of free intraperitoneal gas. However, this is a supine view, on which it is extremely difficult to demonstrate pneumoperitoneum. If there is serious clinical concern for this complication, CT would be recommended.
Single portable chest radiograph was provided. Lung volumes are low. Streaky retrocardiac and right lower lobe opacities are likely atelectasis. There is no focal consolidation, pleural effusion or pneumothorax. Cardiomediastinal silhouette is unchanged. Clips and spinal hardware are incompletely visualized in the lumbar spine.
ET TUBE TIP IS RELATIVELY HIGH, AT THE THORACIC INLET, 9 CM ABOVE THE CARINAL. NG TUBE PASSES BELOW THE DIAPHRAGM TERMINATING IN THE STOMACH. ECMO CATHETER IS IN PLACE. SWAN-GANZ CATHETER TIP IS IN THE RIGHT LOWER LOBE PULMONARY ARTERY. WIDESPREAD PARENCHYMAL CONSOLIDATIONS ARE UNCHANGED AS WELL AS CARDIOMEGALY.
Left lower lobe moderate atelectasis/consolidation is unchanged with possible small pleural effusion. Right lower lung opacities have increased which could be atelectasis or pneumonia. The patient has a right-sided pectoral with pacemaker with three leads, one in atrium and two in right ventricle. Severe cardiac enlargement is stable.
Comparison is made with prior study performed four hours earlier. Widened mediastinum is unchanged. Moderate-to-severe pulmonary edema has worsened. NG tube tip is 1.8 cm above the carina. Right IJ catheter tip is in the right atrium, can be withdrawal a couple of centimeters for more standard position. There are low lung volumes. Bibasilar atelectases are larger on the left side. There is no evident pneumothorax. Bilateral small pleural effusions are larger on the left side. NG tube tip is high, is in the mid esophagus, should be advanced for more standard position. Mediastinal and chest tubes are in place. In the followup study, NG tube has been repositioned.
As compared to the previous radiograph, the tip of the endotracheal tube is projecting 5.5 cm above the carina. Swan-Ganz catheter in the main pulmonary artery. Bilateral pleural and mediastinal drains in situ. Millimetric left apical pneumothorax. Bibasilar areas of atelectasis. No evidence of tension.
A portable semi-erect frontal chest radiograph demonstrates an endotracheal tube which terminates approximately 2.7 cm above the carina, in the mid to low thoracic trachea. The heart is mildly enlarged. There is mild to moderate pulmonary edema, as well as a possible right pleural effusion with associated atelectasis. It is difficult to evaluate for focal consolidation in the right lower lung, given overlying opacities. Allowing for this, no definite focal consolidation is identified.
As compared to the previous radiograph, no relevant change is seen. The lung volumes have slightly decreased, emphasizing the extent and severity of the bilateral parenchymal opacities. However, no substantial progression is seen. The left chest tube is in unchanged position. No visible pneumothorax. Unchanged appearance of the cardiac silhouette.
Interval extubation. Decrease in extent of pulmonary edema as well as slight improvement in extent of bibasilar atelectasis. Small pleural effusions are present, but there is no visible pneumothorax.
Heart size and mediastinum are stable. There is interval development of vascular enlargement/mild pulmonary edema. There is no interval development of visible pleural effusion. No pneumothorax is seen. The patient was extubated in the meantime interval.
Right internal jugular central venous catheter terminates in the region of the mid SVC. Endotracheal tube terminates approximately 6.7 cm above the level of the carina. An enteric tube is high in position, terminates in the mid thorax, side port above the level of the carina. Calcifications noted along the right diaphragm/inferior pleural. Mild bibasilar opacities are better assessed on CT. No large pleural effusion seen. Cardiac silhouette is not enlarged.
Semi-erect frontal view of the chest was obtained. Left PICC terminates in the upper SVC, and tracheostomy and PEG are in stable position. Blunting of the left costophrenic angle is compatible with a small left pleural effusion, similar to prior. Retrocardiac opacity is compatible with atelectasis and similar to prior. Right basilar opacity has worsened medially, and a new patchy opacity has developed peripherally at the right lung base. No pneumothorax. The cardiomediastinal silhouette is normal.
Interval increase in lung volumes. The heart size is normal. Prominent central pulmonary arteries could reflect pulmonary arterial hypertension in this patient with COPD who is status post placement of multiple endobronchial coils. Upper lobe predominant emphysema is present. Previously reported basilar lung opacities have nearly completely resolved. Questionable small pleural effusions are difficult to assess due to portable technique and dense overlying breast tissue.
A left PICC is again demonstrated, however the catheter is not seen beyond the level of the brachiocephalic, obscured by overlying soft tissues. There has been interval removal of a left internal jugular central venous catheter and NGT, and the patient is now extubated. There is no pneumothorax, focal consolidation, or pleural effusion. A benign-appearing subcentimeter sclerotic lesion within the proximal right humerus is again demonstrated.
Previous mild bibasilar atelectasis and interstitial edema have nearly resolved. Moderate cardiomegaly persists. Mediastinum has a normal postoperative appearance. There is no pneumothorax. Tiny right pleural effusion is probably not clinically significant.
The heart is borderline enlarged. The pulmonary vasculature is within normal limits with no signs of congestion. No lung opacity seen. No pleural effusion. Left PICC line again noted with its tip in the SVC.
There are new regions of consolidation in the left lung, particularly over the left lung apex and left midlung. Linear streaky bibasilar opacities may be secondary to atelectasis. The cardiomediastinal silhouette is unchanged, atherosclerotic calcifications again noted at the aortic arch. Vertebroplasty changes are noted in the mid thoracic spine.
Interval improvement in amount of pulmonary edema. Swan-Ganz catheter in good position. Ongoing bilateral effusions and atelectasis.
The ET tube is 5.0 cm above the carina. NG tube tip is in the stomach. There is new patchy infiltrate most marked in the right lower lobe. But also affecting the right upper lobe and left lower lobe. This is much worse than on the study from 1 hr prior. The heart is upper limits normal in size. There is pulmonary vascular redistribution. There is no effusion.
ET tube ends 5.2 cm above carina. Left subclavian line is in mid SVC. NG tube is in the stomach and there is tooth crown in the stomach as shown on recent CT. There is left chest tube projecting in upper hemithorax without visible pneumothorax. Right perihilar atelectasis has improved. Bibasilar pleural effusions with atelectasis which is small to moderate are unchanged. Volume overload is minimal and stable.
Left PICC line tip is at the level of lower SVC. Heart size and mediastinum appear to be decreased in the weeks as compared to the previous study, most likely consistent with decrease in the mediastinal hematoma. Left pleural effusion is noted. No appreciable pneumothorax is seen. No pulmonary edema is seen.
As compared to the previous radiograph, the known right pleural effusion is constant in extent and severity. Subsequent right basilar atelectasis is also unchanged. Moderate cardiomegaly. Unchanged alignment of the sternal wires. Unchanged appearance of the left lung parenchyma.
The endotracheal tube and NG tube and left IJ line have been removed. The heart continues to be moderately enlarged and there continues to be dense left lower lobe consolidation. Due to the opacity in the left lower lobe, it is difficult to tell if an effusion is also present. There is mild pulmonary vascular redistribution. The right-sided PICC line is unchanged.
As compared to the previous radiograph, no relevant change is seen. The 2 pigtail catheters in the left hemi thorax as well as the effusion on the right are unchanged. On the left, there is no evidence of pneumothorax and no change in extent of the pleural effusion. Moderate cardiomegaly, mild retrocardiac atelectasis. Unchanged appearance of the hilar structures.
In comparison to previous radiograph from earlier the same date, there has been little change in the appearance of the chest except for improved aeration in the left retrocardiac region and development of a very small left apical pneumothorax.
As compared to the previous radiograph, no relevant change is seen. The extent of the bilateral pleural effusions and of the subsequent areas of atelectasis are constant. Constant borderline size of the cardiac silhouette. The right PICC line is also unchanged. No new focal parenchymal process is visualized.