Datasets:
BoghdadyJR
/
mimicxray

Dataset card Data Studio Files Community
1
image
imagewidth (px)
512
512
report
stringlengths
7
1.12k
Left chest wall dual lead pacing device is again noted. The lungs are clear without focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is within normal limits. Old posterior left rib fractures are noted. There is no free intraperitoneal air. Lumbar spine intervertebral disc hardware is partially visualized.
Right PICC terminates in the mid superior vena cava. Feeding tube continues to terminate in the proximal stomach. Cardiomediastinal contours are unchanged. Worsening left basilar opacity, likely a combination of atelectasis and pleural effusion, but infection should also be considered in the appropriate clinical setting.
As compared to the previous radiograph, the position of the bilateral chest tubes, the central access line, the nasogastric tube and the endotracheal tube are constant and unchanged. There is no evidence of pneumothorax. Air collection in the cervical soft tissues are constant. No pleural effusion. Unchanged appearance of the cardiac silhouette.
Mediastinum is normal. Right PICC line terminates at the level of mid SVC. Heart size is normal. Lungs are clear. There is no pleural effusion or pneumothorax.
Increasing bibasilar opacities which would be concerning for aspiration or a worsening infectious process. There is also a persistent diffuse reticulonodular interstitial abnormality which likely is not significantly changed. Overall cardiac and mediastinal contours are unchanged. Right subclavian PICC line and tracheostomy tube are in unchanged position. Severe degenerative changes of the right glenohumeral joint. No evidence of pneumothorax. No large effusions, although there is some blunting of the left costophrenic angle which could reflect a small effusion.
1. There is marked interval improvement with resolution of the pulmonary edema, although there is residual subtle patchy opacity at the right lung base which could represent resolving asymmetric pulmonary edema, although pneumonia could also have this appearance. Clinical correlation is advised. The lungs appear hyperinflated consistent with underlying emphysema. Overall cardiac and mediastinal contours are stable. No evidence of pneumothorax.
New atelectasis is present at the right lung base reflecting or partially contributing to greater elevation of the right hemidiaphragm. Lungs are otherwise clear. Heart size normal. Hilar and mediastinal contours unremarkable. No appreciable pleural abnormality.
1. Interval appearance of bibasilar airspace consolidations, right greater than left which are concerning for pneumonia or aspiration. No evidence of pulmonary edema. No pneumothorax. The heart is upper limits of normal in size given portable technique. Mediastinal contours are within normal limits. No acute bony abnormality.
Lungs are well-expanded and clear. The cardiac silhouette is unchanged. Patient is status post CABG and pacemaker/ICD device placement with leads ending in the right atrium and right ventricle. Median sternotomy wires are intact. No pneumothorax, pleural effusion, or consolidation. No acute displaced rib fractures.
Portable semi-upright AP view of the chest was provided. The tip of the endotracheal tube resides approximately 3.2 cm above the carina. The OG tube tip is located at the level of the distal esophagus. Advancement is recommended. There is mild plate-like atelectasis in the right lower lung. Otherwise, the lungs appear clear, though lung volumes are low. Overall, cardiomediastinal silhouette appears normal. No gross osseous deformities are seen.
Mild enlargement of the cardiac silhouette is unchanged. The thoracic aorta remains unfolded, and the mediastinal and hilar contours are stable. Pulmonary vascularity is normal. No focal consolidation, pleural effusion or pneumothorax is present. The extreme right costophrenic angle, however, is excluded from the field of view. There are no acute osseous abnormalities.
In comparison to the chest radiograph obtained 1 day prior, bilateral lung volumes are substantially lower with substantial right middle and lower lobe atelectasis and rightward mediastinal shift. Opacities at the left lung base appear unchanged and may be consistent with atelectasis or pneumonia. There probably small, right greater than left pleural effusions. Heart size is mildly enlarged with new, mild pulmonary edema. Support devices and lines are unchanged and appropriately positioned.
Portable semi-upright radiograph of the chest demonstrates low lung volumes with resulting bronchovascular crowding. There is persistent retrocardiac opacity consistent with atelectasis and small pleural effusion. There has been slight interval improvement in the degree of right pleural effusion, which may be due to patient positioning. Pulmonary edema has resolved. The endotracheal tube ends 3.8 cm from the carina. A nasogastric tube courses into the stomach and out of the field of view. A left-sided PICC line ends at the cavoatrial junction.
Upright portable view of the chest demonstrates right internal jugular central venous catheter tip projecting over mid SVC. Dual-chamber pacemaker leads are in unchanged position. Lung volumes are low, which accentuate bronchovascular markings. Mild pulmonary vascular congestion persists. Left costophrenic angle is blunted, suggestive of possible small pleural effusion. There is no right pleural effusion. No pneumothorax. Heart is mildly enlarged. Left atrium is prominent. Heavy aortic arch calcifications are noted. Bibasilar opacities are likely atelectasis.
As compared to the previous radiograph, the patient has been extubated. And the nasogastric tube was removed. The venous introduction sheet in the right internal jugular vein remains in situ. Increasing left retrocardiac atelectasis. Slightly increasing left pleural effusion. No pulmonary edema. Unchanged appearance of the cardiac silhouette.
There is interval repositioning of right PICC with tip now in the lower SVC. Cardiomediastinal silhouette is stable. Lungs are clear. There is no pleural effusion or pneumothorax.
Enteric tube tip is near gastroduodenal junction. Minimally more prominent right basilar opacity. Mi right pleural effusion, similar. Mild retrocardiac opacity, new or better seen, likely atelectasis, consider pneumonitis in the appropriate clinical setting. Shallow inspiration accentuates heart size. Borderline pulmonary vascularity. No pneumothorax.
No failure, no pneumonia.
Cardiomediastinal silhouette and hilar contours are normal. Lung volumes are low but clear. There is no pleural effusion or pneumothorax.
Cardiac size is normal. Biapical opacities reflect soft tissues about the mandible. The lungs are clear. There is no pneumothorax or pleural effusion. The enteric tube terminates in the stomach with side port extending beyond the GE junction.
Interval placement of an ETT, with the tip approximately 4.5 cm from the carina. Interval placement of a nasogastric tube, which traverses the diaphragm and ends in the stomach with the side hole just distal to the gastroesophageal junction. The lungs are hyper-expanded. Increased opacity in the left lower lung with silhouetting of the lateral border of the descending aorta but preservation of air bronchograms, new since the exam earlier on the same day. Right basilar atelectasis. No pleural effusion, pneumothorax, or pulmonary edema. The cardiac and mediastinal contours as well as hila and pleura are unchanged. Incidental interposition of the colon between the right hemidiaphragm and liver. No sub-diaphragmatic intra-abdominal free air. No acute osseous abnormality.
The patient was extubated in the meantime interval as well as the NG tube has been removed. Right internal jugular line is deep in the right atrium and should be pulled back approximately 2.5 cm. No pneumothorax is seen. Minimal left basal atelectasis present.
As compared to the previous radiograph, the lung volumes have slightly increased, potentially resulting from increased ventilatory pressure. There is unchanged evidence of bilateral basal opacities, with the morphology that rather suggest of atelectasis than pneumonia. However, both opacities show visible air bronchograms. The opacity on the right has minimally increased in extent. The opacity on the left is constant. Unchanged appearance of the cardiac silhouette. No pleural effusions.
Nasogastric tube is again seen coursing below the diaphragm with the tip projecting over the stomach. Endotracheal tube has its tip 4 cm above the carina and is now in satisfactory position. Patchy opacities are now seen at both bases which may reflect atelectasis, although aspiration and early pneumonia should also be considered. No obvious pneumothorax is seen. Overall cardiac and mediastinal contours are stable.
Lung volumes are mildly diminished. A linear opacity in the left lower lung could be a band of atelectasis or left-sided minor fissure. A 6 mm wide curvilinear opacity projecting to the right of the hilus superiorly and over the hilus inferiorly is very unusual. It could be a chronic middle lobe collapse or an unusual band of sublobar atelectasis. Lateral view might be helpful. Any prior chest radiograph should be consulted. Heart size is top-normal. There is no pleural abnormality.
As compared to the previous radiograph, the patient has been extubated and the nasogastric tube has been removed. The surgical clips in the left subclavian catheter are unchanged. The pre-existing pleural effusion has slightly decreased. The lung appears better ventilated than on the previous image. Moreover, the pre-existing signs of mild fluid overload are decreasing in severity. A relatively substantial left lower lobe atelectasis persists. Borderline size of the cardiac silhouette. No pneumothorax.
The ETT is 3.6 cm above the carina. The pacer wire extends from the IJ and projects over the expected location of the right ventricle. NG tube tip is in the stomach. There are bilateral lower lobe infiltrates and small bilateral effusions. There is pulmonary vascular redistribution with ill-defined vascularity compatible with fluid overload. Compared to the study from earlier the same day the pulmonary status appear similar.
Portable upright view of the chest demonstrates low lung volumes, which accentuate bronchovascular markings. Bibasilar opacities most likely represent atelectasis. Hilar and mediastinal silhouettes are unchanged. Heart size top normal. There is no pulmonary edema. No pneumothorax. Descending aorta demonstrates heavy calcifications. Partially imaged upper abdomen is unremarkable.
The lung volumes are low. There is no consolidation, pulmonary edema, pleural effusion or pneumothorax. The cardiac silhouette is mildly enlarged. The mediastinal contours are normal.
CHEST, SINGLE AP PORTABLE VIEW.No previous chest x-rays on PACS record for comparison. Lordotic positioning. Heart size is borderline. No CHF, focal infiltrate, effusion, or pneumothorax. Allowing for overlying iatrogenic materials, no radiopaque foreign body is detected. No free air is seen beneath the diaphragm on this upright film. The visualized bowel gas pattern is nonspecific.
A portable frontal chest radiograph demonstrates a nasogastric tube with the tip within the nondilated stomach. The heart size is normal and the aorta is tortuous. There is elevation of the right hemidiaphragm and bibasilar atelectasis without focal consolidation or pulmonary edema. There is no pneumothorax.
Nasogastric tube tip terminates within the stomach. The remainder of the chest is unchanged. The cardiac, mediastinal, and hilar contours are stable. The lungs are clear. No pleural effusion or pneumothorax is present.
As compared to the previous radiograph, the nasogastric tube shows a normal course, the tip of the tube is not included on the image. The tracheostomy tube is unchanged. Moderate cardiomegaly and mild fluid overload persist. No pneumonia, no pleural effusions.
Previously seen left rib fractures are again noted, and the cardiac and mediastinal contours are normal. No consolidation, pleural effusion or pulmonary edema is seen. Small apical pneumothorax is seen on the left, and known right apical pneumothorax is not well visualized.
Normal heart size, mediastinal and hilar contours. Previously seen left lower lobe opacity largely resolved. No pleural effusion or pneumothorax.
NG tube tip is in the stomach. There small bilateral pleural effusion is. There is minimal compressive changes at the bases. The heart is mildly enlarged. There is minimal pulmonary vascular redistribution.
Monitoring and supporting devices are in standard position. Lateral lung volumes are low. Increased retrocardiac density, reflecting left lower lung atelectasis and minimal right lower lung atelectasis are unchanged. There are no new lung opacities of concern. Mediastinal silhouette is stable.
Enteric tube traverses the diaphragm with tip not seen. The right internal jugular venous catheter ends in the low SVC, unchanged. Lung volumes are low, unchanged. Moderate cardiomegaly persists and is overall unchanged. Prominence of pulmonary vessels is also overall unchanged. Moderate to mild pulmonary edema is probably also grossly unchanged when accounting for redistribution. Small left pleural effusion is overall similar. Pleura effusion of the right, if any, is minimal. No pneumothorax.
As compared to the previous radiograph, the nasogastric tube has been removed. The abdominal drains and the right PICC line remains in situ. The lung volumes are low. There is no evidence of larger pleural effusions but an area of atelectasis at the left lung base is seen. No pneumonia. No pneumothorax. Unchanged mediastinal and cardiac contours.
No pleural effusion or pneumothorax. Given the low lung volumes, no consolidations concerning for pneumonia. Cardiac size is top normal.
Mild cardiomegaly is present, with tortuosity of the thoracic aorta noted. There is diffuse calcification of the thoracic aorta. There is perihilar haziness and vascular indistinctness compatible with mild pulmonary edema. Small bilateral pleural effusions are noted, with bibasilar airspace opacities likely reflecting atelectasis though infection or aspiration is difficult to exclude. There is no pneumothorax. Diffuse demineralization of the osseous structures is noted.
Widening of the upper mediastinum is likely due to a combination of postoperative change and accentuation by apical lordotic projection. There remains a localized pneumomediastinum, likely postoperative in etiology. Within the lungs, patchy left retrocardiac opacity has slightly worsened, and may be due to atelectasis, aspiration, and less likely a developing focus of infection. No pleural effusion or pneumothorax.
As compared to the previous image, the patient has developed. Moderate to severe pulmonary edema. The patient has been intubated. The tip of the endotracheal tube projects 4.5 cm above the carina. No pneumothorax. Moderate cardiomegaly with bilateral moderate pleural effusions.
An endotracheal tube terminates above the level of the carina. The side hole of the oro-gastric tube is around the level of the GE junction. The lungs are well expanded and clear. There is no focal consolidation, effusion, or pneumothorax. No displaced rib fracture is apparent.
As compared to the previous radiograph, the patient has developed developed a mild right pleural effusion, limited to the bases of the right hemi thorax. The small blunting of the costophrenic sinus on the left is unchanged. Mild cardiomegaly without pulmonary edema. . Moderately enlarged pulmonary arteries are unchanged. No pneumonia, no pneumothorax. The right pectoral pacemaker is constant in position.
In the interval since the prior study, there has been development of a moderate left pleural effusion with overlying atelectasis, left base consolidation cannot be excluded. There is slight blunting of the right costophrenic angle and a small pleural effusion may be present. The cardiac and mediastinal silhouettes are grossly stable. No evidence of pneumothorax is seen. No overt pulmonary edema is seen.
As compared to the previous radiograph, the patient is after right segmentectomy. A 1-cm pneumothorax is visualized at the right lung apex. There is no evidence of tension. A right chest tube is in expected position. Mild postoperative atelectasis at the right lung base. Moderate cardiomegaly, minimal blunting of the left costophrenic sinus, likely caused by a small basal atelectasis. Moderate cardiomegaly and tortuosity of the aorta. No overt pulmonary edema.
Patient status post prior esophagectomy and gastric pull-through with an expected postoperative appearance of the mediastinum. There is a persisting small right apical pneumothorax. Unchanged bibasilar atelectasis left greater than right as well as a small left pleural effusion. Surgical clips project over the left upper quadrant.
The lungs are essentially clear. There are no pleural effusions or pneumothorax. The cardiomediastinal and hilar contours are normal. Pulmonary vascularity is normal.
Compared to prior, left chest tube has been withdrawn slightly and projects over the medial cardiac border. Remainder of the lines and tubes are unchanged. Persistent small to moderate right pneumothorax. There is substantial subcutaneous emphysema. Bilateral rib fractures are again seen.
There is bibasilar opacities, likely representing atelectasis on the right, however the opacities in the left lower lung are slightly more confluent and may represent atelectasis or pneumonia. No large pleural effusion or pneumothorax. Mild to moderate cardiomegaly. The cardiomediastinal and hilar contours are stable.
Comparison is made with prior study performed a day earlier. There are low lung volumes. Lines and tubes are in unchanged standard positions. Bibasilar consolidations have minimally improved. Small left pleural effusion has probably minimally increased, though the change could be just difference is positioning of the patient. Cardiomediastinal contours are stable. Pulmonary edema is stable.
As compared to the previous radiograph, there is no relevant change. Left pectoral pacemaker and nasogastric tube in situ. Mild fluid overload with minimal atelectasis at the lung bases but no pleural effusions or indications for pneumonia. No pneumothorax.
Since the prior study. A has been interval increase in bilateral pleural effusions as well as interval development of moderate interstitial pulmonary edema, potentially related to the recent surgery. Heart size is severely enlarged, unchanged. Widespread mediastinal calcified lymphadenopathy is unchanged. There is no pneumothorax Reassessment of the patient after diuresis is recommended.
As compared to the previous radiograph, the patient has received a right-sided PICC line. The tip of the line projects over the mid SVC, course of the line is unremarkable. There is no evidence of complication, notably no pneumothorax. Right-sided pleural effusion has minimally decreased. Otherwise, the appearance of the lung parenchyma and of the cardiac silhouette is constant. Unchanged signs of mild-to-moderate fluid overload.
Comparison is made to the left-sided PICC line whose distal lead tip is in the mid SVC. The heart size is upper limits of normal. There has been removal of the left-sided chest tubes since the previous study. There is some atelectasis at the left lung base. There are no signs for overt pulmonary edema. There is a residual right IJ Cordis. No pneumothoraces are seen on either side.
Endotracheal tube and central venous catheter are in standard position, and cardiomediastinal contours are stable allowing for positional differences. Persistent pulmonary vascular congestion and improving left mid and lower lung opacities, likely due to a combination of consolidation and atelectasis in this patient with recurrent collapse of the left lung on previous serial radiographs. Moderate left and small right pleural effusions appear similar. Poorly defined opacity in the right upper lobe has slightly improved. Otherwise, no relevant short-interval change.
As compared to the previous radiograph, the patient has undergone VATS. A left chest tube is in situ. There is a small residual pneumothorax without evidence of tension. Mild scarring at the right lung apex. Normal size of the cardiac silhouette. No larger pleural effusions.
A new tracheostomy tube is present, the tip is 15 mm above the carina. A right PICC line is present the tip is in the right atrium. There is patchy consolidation in both bases left greater than right. There is no CHF or pneumothorax.
Again seen is an intra-aortic balloon pump, the tip is 1.5 cm below the top of the aortic arch. The cardiomediastinal contour is unchanged. Persistent prominence of bilateral hila consistent with pulmonary vascular congestion. No overt pulmonary edema. No pneumothorax seen.
The examination is limited. There is motion artifact and low volumes are low. Within this limitation, an opacity in the lingula appears likely similar since recent prior studies. For further evaluation a repeat chest radiograph could be obtained.
Compared to the prior study there is no significant interval change.
There is increased atelectasis in both lower lungs. The upper lungs are clear. Tubes and lines are unchanged.
As compared to previous radiograph of 1 day earlier, recently described left upper lobe alveolar opacities have improved. Remainder of exam is not appreciably changed when consideration is given to differences in technique and projection.
As compared to chest radiograph from earlier today, left-sided pleural drain has been removed. No visible pneumothorax. Extensive subcutaneous emphysema has increased. Bibasilar atelectasis are stable. Heart size stable.
Cardiac size is enlarged. No focal consolidation. No evidence of pulmonary edema. There is no pneumothorax or pleural effusion. Again seen is the increased pulmonary vascularity bilaterally. Left PICC with tip in the mid SVC.
As compared to the previous radiograph, the size of the cardiac silhouette has decreased. The monitoring and support devices are constant. Minimal atelectasis at the left lung bases. No pneumonia, no pulmonary edema. No pleural effusions.
No previous images. The heart is normal in size and there is no vascular congestion, pleural effusion, or acute focal pneumonia. Right PICC line extends to the lower portion of the SVC. Of incidental note is a cervical spinal fusion device.
The patient is somewhat rotated on today's study. A tracheostomy is in-situ, unchanged in position compared to the prior study. A left-sided PICC line terminates in the mid SVC. No pneumothorax, consolidation or pleural effusion seen.
As compared to the previous radiograph, no relevant change is seen. The monitoring and support devices are constant. Atelectasis of the left lower lobe, potentially associated with a small pleural effusion. The extent of the effusion does not appear to have substantially increased. Moderate cardiomegaly persists. No pulmonary edema.
Portable upright AP chest radiograph obtained. Dual-lead pacer is unchanged in position. Lung volumes are similar to prior with interval development of mild interstitial edema. There is no pleural effusion or pneumothorax. Cardiomediastinal silhouette is stable. Bony structures are intact.
Portable AP upright image of the chest. The trachea is noted to be deviated to the right. The lungs are well expanded. Opacity at the medial right lung base, which represent atelectasis but cannot exclude pneumonia or aspiration in the right clinical setting. Mild atelectasis is seen in the left lung base. There is no pleural effusion or pneumothorax. The cardiomediastinal silhouette is chronically enlarged.
There is persistent diffuse opacification of the right upper lobe stable compared to prior. There is also persistent left basilar atelectasis as well as persistent opacification in the left lower lobe, although less apparent today. There is no pneumothorax. There is no pulmonary vascular congestion.
Newly inserted. Left chest tube. No pneumothorax. Decrease of a pre-existing left pleural effusion. On the right, the effusion has moderately increased. Borderline size of the cardiac silhouette is unchanged.
The heart size is severely enlarged and there is marked pulmonary vascular redistribution. With hazy alveolar infiltrates most marked in the lower lobes there small bilateral pleural effusions have increased compared to prior
As compared to the previous radiograph, the patient has been extubated and all monitoring and support devices, with the exception of the right internal jugular vein catheter, have been removed. The sternal wires are in unchanged normal alignment. No larger pleural effusions or pneumothorax are noted. No pulmonary edema. No pneumonia. Moderate cardiomegaly persists.
Lung volumes are low and there is volume loss in both lower lobes with a more focal area of opacity in the right lower lobe. It is unclear if this is due to atelectasis or if it is an early infiltrate. There is a small right effusion.
The tip of the endotracheal tube projects over the mid thoracic trachea. The tip of the nasogastric tube projects below the level the diaphragms but beyond the field of view of this radiograph. A left central venous catheter tip projects over the mid SVC. Low bilateral lung volumes. Increasing hazy opacities throughout the right lung likely reflect a layering pleural effusion. More discrete opacities project over the right lower lung zone and may reflect atelectasis and/or pneumonia. Small left pleural effusion. No pneumothorax identified. The size and appearance of the cardiomediastinal silhouette is unchanged.
Cardiomegaly is substantial, unchanged. There is minimal interval improvement in overall still moderate interstitial pulmonary edema. No definitive focal consolidation to suggest infection demonstrated. No appreciable pleural effusion is seen. Cardiomediastinal silhouette is stable. Sternotomy wires are unchanged.
There has been interval placement of endotracheal tube with tip approximately 3.0 cm from the carina. Enteric tube seen with tip in the gastric fundus. Left lung base opacity persists. Streaky right midlung opacity is likely atelectasis given lower lung volumes. Cardiomediastinal silhouette is within normal limits. Cervical and lumbar fixation hardware is partially visualized.
Left apical thoracostomy tube reflects intervening surgery. Tiny left apical pneumothorax not clinically significant. No appreciable pleural effusion. There has been a slight increase it in the extent of abnormality in the left suprahilar lung attributable to effects of biopsy on the known lung mass. Right lung is clear. Heart size normal.
Lungs are clear of focal consolidation. The cardiac silhouette is enlarged but stable. Chronic deformity of the proximal left humerus suggests prior healed fracture.
Right internal jugular line tip is at the level of mid to lower SVC. Heart size and mediastinum are stable. There is interval progression of widespread parenchymal opacities concerning for interval development of are drug toxicity within the lungs or diffuse infectious process. Left pleural effusion is small to moderate, unchanged as well as left retrocardiac consolidation Further assessment with chest CT would be beneficial in that specific case.
ET tube is seen with tip approximately 8.2 cm from the carina. Diffuse bilateral parenchymal opacities are again noted, most dense in the left mid lung and in the retrocardiac region silhouette the descending thoracic aorta, new from prior. Cardiac silhouette is enlarged likely exaggerated by portable technique and low lung volumes. No acute osseous abnormalities.
As compared to the previous radiograph, no relevant change is seen. Severe scoliosis with subsequent asymmetry of the ribcage. Normal size of the cardiac silhouette. Normal hilar and mediastinal structures. No pneumonia, no pulmonary edema. No pleural effusions.
Substantial interval progression of pulmonary edema is noted currently also associated with pleural effusions. The patient has been intubated with the ET tube tip being 5.5 cm above the carinal. No pneumothorax appreciated
The rapid improvement in opacification at the right base indicates this was dependent edema. There has been some improvement in lymphatic engorgement in the left lung as well. Lower lobe remains largely atelectatic and small pleural effusion persists, with pigtail pleural drainage catheter still in place. Heart is mildly enlarged. Left PIC line ends in the low SVC.
Interval placement of Dobbhoff tube terminating within the stomach. Otherwise no change since recent study.
Given the clinical history, despite this benign looking chest radiograph, if there is further suspicion despite this benign chest radiograph, consider CT of the chest for further workup.
UPPER TRACHEAL STENT IS IN PLACE. HEART SIZE AND MEDIASTINUM UNREMARKABLE. LUNGS ARE CLEAR. THERE IS NO APPRECIABLE PLEURAL EFFUSION OR PNEUMOTHORAX. POST THORACOTOMY CHANGES ON THE RIGHT ARE SIMILAR TO PREVIOUS EXAMINATION.
The right-sided chest tubes remain in place. There is stable scarring and volume loss within the right hemithorax with no obvious residual basilar right hydropneumothorax appreciated. No pulmonary edema. Streaky opacity at the left base likely reflects scarring or subsegmental atelectasis. Stable cardiac enlargement status post median sternotomy with valve replacement.
AP portable upright view of the chest. There has been interval removal of the PICC line. Mild elevation of the left hemidiaphragm is again noted. There is mild left basal atelectasis. Lungs are otherwise clear. Heart size is grossly stable. There is stable prominence of the mediastinum. Bony structures appear grossly intact. No free air below the right hemidiaphragm is seen.
Portable AP upright chest radiograph obtained. The lungs appear clear without focal consolidation, effusion or pneumothorax. Cardiomediastinal silhouette is stable and normal. Bony structures are intact though degenerative changes at both AC joints are noted.
Indwelling support and monitoring devices are unchanged in position. Cardiomediastinal contours are stable. Improving right juxtahilar opacity likely due to atelectasis. Minimal residual atelectasis in the left perihilar and basilar region. Otherwise, clear lungs. No visible pneumothorax on this semi-upright radiograph.
Tip is unchanged in position in the mid SVC. Probable developing pseudotumor in the right side. Stable background pulmonary edema.
Heart size is enlarged. Mediastinal silhouette is stable. Sternotomy wires are stable. Lungs are essentially clear. No pleural effusion or pneumothorax. Extensive calcifications of the mitral annulus noted.
The Dobbhoff catheter tip is in the stomach. Tracheostomy tube and right IJ line are unchanged. There are increased bilateral lower lobe infiltrates with volume loss in both lower lobes and small bilateral effusions. There is pulmonary vascular redistribution.
ET tube tip 5.9 cm above the carina. Right PICC line tip over mid/ distal SVC. The NG type tube is no longer visualized. No pneumothorax detected. Cardiomediastinal silhouette is unchanged. Vascular plethora, hazy opacity in the right mid and lower zones, and increased retrocardiac density are also similar to the prior study.
As compared to the prior study, there have been several new consolidations overlying the mid and upper right lung as well as mid left lung concerning for infectious process. Aspiration would be another possibility. Small amount of left pleural effusion is most likely present. Cardiomediastinal silhouette is unchanged.
In comparison with the earlier study of this date, the chest tube is on waterseal, and there is no evidence of pneumothorax. The bibasilar opacifications are slightly improved. Monitoring and support devices are otherwise unchanged.