itsanmolgupta/mimic-cxr-dataset · Datasets at Hugging Face

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	Supine and portable AP view of the chest was provided. There has also been placement of an NG tube with its tip in the left upper quadrant, likely in the stomach. Otherwise no change.	NGT position in appropriate position.
	Single portable view of the chest. Somewhat ill-defined interstitial markings seen throughout the lungs. There is no confluent consolidation. Cardiac silhouette is enlarged but likely in part accentuated by technique. Atherosclerotic calcifications noted at the aortic arch. Left chest wall dual-lead pacing device is identified.	Increased markings throughout the lungs which could be chronic, although superimposed interstitial edema is also suspected.
	Mild cardiomegaly is stable. Mediastinal and hilar contour is are also stable. There is no pleural effusion or pneumothorax. The lungs are expanded without focal consolidation concerning adenoma. Pulmonary vasculature is within normal limits. The upper abdomen is unremarkable. Dual lead pacemaker is noted with leads terminating in the right atrium and right ventricle as expected.	No acute cardiopulmonary process.
	Motion limits detailed evaluation. There is faint left basilar opacity potentially atelectasis. Elsewhere the lungs are grossly clear. The cardiomediastinal silhouette is stable. No acute osseous abnormalities.	Probable left basilar atelectasis. Otherwise, no definite acute cardiopulmonary process.
	There is moderate cardiomegaly that is increased compared to prior and bilateral pleural effusions that are also larger. There is a right IJ line with tip in the upper SVC. There is volume loss in both lower lungs.	Worsened fluid status.
	The heart size is normal. The mediastinal and hilar contours are unremarkable. Lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. Marked degenerative changes of the left glenohumeral joint are visualized with subchondral cysts and sclerosis.	No acute cardiopulmonary abnormality.
	Assessment is somewhat limited due to patient rotation and kyphosis. Lung volumes are low. Heart size is mildly enlarged. The aorta remains tortuous. Perihilar hazy opacities with vascular indistinctness is more pronounced on the right compared to the left, likely reflective of asymmetric mild to moderate pulmonary edema. No pneumothorax is demonstrated. Small right pleural effusion is likely present. No acute osseous abnormalities are seen.	Perihilar hazy opacities and vascular indistinctness, more pronounced on the right compared to the left likely reflects asymmetric mild to moderate pulmonary edema. Probable small right pleural effusion.
	There is near complete opacification of the left hemithorax likely reflective of a combination of large pleural effusion and atelectasis. Heart size cannot be assessed due to the presence of the left hemithorax opacification. Dense atherosclerotic calcifications of the thoracic aorta are present. No pulmonary vascular congestion is seen. The right lung is grossly clear. No pneumothorax is noted. No acute osseous abnormalities are visualized.	Near-complete opacification of the left hemithorax likely due to a combination of a large left pleural effusion and atelectasis. CT of the chest is recommended to exclude an obstructing central endobronchial lesion.
	A right-sided PICC terminates at the cavoatrial junction without evidence of pneumothorax. There are low lung volumes. No new focal consolidation is seen. There is no large pleural effusion. Prominence of the right hilum is grossly stable.	Right-sided PICC now terminates at the cavoatrial junction. No evidence of pneumothorax.
	The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. Atherosclerotic calcifications are noted of the aortic arch. The lungs are mildly hyperexpanded but clear. There is no definite pleural effusion or pneumothorax, though evaluation is limited on this supine examination.	No acute intrathoracic process.
	The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax.	No acute intrathoracic process.
	There are no lung opacities concerning for pneumonia. Both pleural spaces are normal. Heart size is normal, mediastinal and hilar contours are unremarkable.	No pneumonia.
	There is no appreciable pneumothorax. A right IJ central venous catheter terminates in the upper right atrium. A nasogastric tube enters the stomach, tip not visualized. Small layering pleural effusions with bibasilar subsegmental atelectasis are unchanged. The heart and mediastinum are within normal limits despite the projection. A third radiopaque tube projects over the add line cervical soft tissues, terminates at the level of the first rib. If there is a second intended device, it ends in the neck.	Stable small bilateral layering pleural effusions with bibasilar subsegmental atelectasis. with Dr.
	Right-sided dual lumen central venous catheter tip terminates in the proximal right atrium, unchanged. The cardiac, mediastinal and hilar contours are unchanged and within normal limits. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are visualized. No subdiaphragmatic free air is seen.	No acute cardiopulmonary abnormality. No subdiaphragmatic free air is visualized.
	Compared to the prior study there is no significant interval change.	No change.
	There continues to be compressive changes at the right base. There continues to be retrocardiac opacity. There is mild pulmonary vascular redistribution. There is no pneumothorax. .	No change.
	Single AP upright portable view of the chest was obtained. The cardiac silhouette remains mildly enlarged. Mediastinal contours are stable, as are hilar contours. No focal consolidation, pleural effusion or evidence of pneumothorax is seen. There is no overt pulmonary edema. Costochondral calcifications are seen.	Persistent mild enlargement of the cardiac silhouette. No overt pulmonary edema.
	The left lung base is densely opacified by a combination of pleural effusion and lower lobe collapse. Heterogeneous density in the right lower hemithorax is also likely a combination of pleural effusion and atelectasis. A large area of vaguely increased radiodensity in the right upper lobe is probably consolidation. Heart size is top-normal. There is no pneumothorax.	Left pleural effusion and lower lobe collapse. Smaller right pleural effusion and less severe atelectasis. Right upper pneumonia.
	There are moderate bilateral pleural effusions with volume loss/infiltrate in both lower lungs. There is mild pulmonary vascular redistribution. The heart size is mildly enlarged. The aorta is calcified and tortuous. Spine demonstrates a mild scoliosis and degenerative changes.	CHF. An underlying infectious infiltrate cannot be excluded.
	Portable chest radiograph demonstrates interval development of moderate pulmonary edema as demonstrated by increased interstitial fluid and central vascular congestion. Mild cardiomegaly is unchanged. Small bilateral pleural effusions are increased in size. There is no pneumothorax. An old left healed clavicular fracture is once again identified.	Interval development of moderate pulmonary edema.
	Portable chest radiograph demonstrates improved vascular plethora and decreased interstitial fluid consistent with overall improved pulmonary edema. Bilateral small pleural effusions are mildly increased in size. Mild cardiomegaly is unchanged. The right minimally enlarged hila is unchanged. Redemonstration of old left healed clavicular fracture.	Improved pulmonary edema with stable mild cardiomegaly.
	The previously noted linear opacities in the bases bilaterally have improved. There are no other new opacities. Heart size is stable. The mediastinal and hilar contours are stable. The pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.	Improvement in prior linear opacities in the bases bilaterally, with almost complete resolution.
	The aortic contour and calcification pattern appears similar compared to prior studies. Descending thoracic aortic contour also appears similar to prior studies, but is obscured inferiorly by adjacent lung and pleural abnormalities. Cardiac silhouette remains enlarged, and is accompanied by upper zone vascular redistribution. Small-to-moderate bilateral pleural effusions are present as well as adjacent basilar atelectasis and/or consolidation, worse on the right than the left. ICD pacing device remains in place with leads in the right atrium and right ventricle.	No portable chest radiographic findings to suggest aortic dissection, but the sensitivity of this study is low for detecting this diagnosis. If there is clinical suspicion for acute aortic dissection, a CT angiogram would be recommended.
	A portable frontal chest radiograph demonstrates a normal cardiomediastinal silhouette and hyperinflated lungs compatible with emphysema. No focal consolidation, pleural effusion, or pneumothorax. No displaced rib fracture is identified. The visualized upper abdomen is unremarkable.	No displaced rib fracture identified. If there is continued concern, dedicated rib radiographs can be obtained. Hyperinflated lungs, consistent with known emphysema.
	AP portable upright view of the chest provided. The bilateral pulmonary hila appear symmetrically prominent which is of unclear etiology though could reflect the presence of lymphadenopathy. Consider dedicated PA and lateral views to further assess. Aside from this, the lungs are clear. The heart size is normal. Mediastinal contour is stable. No pneumothorax or effusion is seen. Bony structures are intact.	Bilateral hilar prominence which could be better assessed with a dedicated PA and lateral view of the chest. Otherwise, unremarkable.
	The enteric tube courses beyond the diaphragm, terminating in the left upper quadrant, likely in the region of the stomach. The lungs are relatively well inflated with obscuration of the costophrenic angles bilaterally, likely a combination of pleural fluid and atelectasis. Heart size is within normal limits and the cardiomediastinal contour is normal. Exuberant costochondral calcifications are noted bilaterally.	Satisfactory position of endotracheal and enteric tubes.
	Extensive diffuse airspace opacities are slightly worse than on , progressively worsening since , accentuated by lower lung volumes. A right PICC terminates in the mid SVC, unchanged. No pneumothorax. Stable mild cardiomegaly. No larger pleural effusions.	Slightly worse extensive airspace opacities since , progressively worsening since , concerning for multifocal infection or severe pulmonary edema.
	Single supine AP portable view of the chest was obtained. A right internal jugular central venous catheter is seen terminating in the low SVC without evidence of pneumothorax. There are prominent right greater than left perihilar opacities. No large pleural effusion is seen, although a trace right pleural effusion would be difficult to exclude. Cardiac silhouette is top normal. Mediastinal contours are unremarkable.	Right internal jugular central venous catheter terminates in the low SVC without evidence of pneumothorax. Right greater than left perihilar opacities may be due to infection vs asymmetric pulmonary edema, other alveolar process not excluded.
	Lung volumes remain low, slightly worse from the prior exam. Opacification in the right lung base with increased rightward shift of the mediastinum loss of the right hemidiaphragm and right heart border interval increase in atelectasis as well as a moderate right pleural effusion that has progressed despite the presence of a drain projecting over the right hemithorax. Small left pleural effusion and is overall unchanged. Unchanged retrocardiac opacity. Moderate edema is worse from the prior exam. A left PICC line is appropriately placed.	Progressive edema and re-accumulation of right pleural effusion despite drain, now moderate in size.
	Compared to the prior study there is no significant interval change.	No change.
	The tip of a left subclavian line overlies the distal SVC. No pneumothorax detected. There are bilateral effusions, with underlying collapse and/or consolidation. There is upper zone redistribution and diffuse vascular blurring, consistent with CHF. The cardiomediastinal silhouette, including prominence of the SVC, is enlarged, but unchanged.	CHF, with bibasilar effusions and underlying collapse and/or consolidation. The possibility of an underlying infectious infiltrate cannot be excluded.
	Tracheostomy tube appears midline and intact. Enteric tube traverses the diaphragm. Right PICC line ends in the low SVC, unchanged. Pigtail catheter projects over the right lower hemithorax and appears intact but its orientation has changed. Lung volumes remain low, but slightly improved from the prior exam. The right pleural effusion has slightly decreased in size, now small. Left pleural effusion, if present, is small. No pneumothorax.	Minimal interval improvement in aeration and decrease in size of small right pleural effusion. Interval change in orientation of right pigtail catheter - correlate with clinical assessment.
	As compared to chest radiograph from earlier today, interval thoracentesis with significant decrease an left-sided effusion which is now small to moderate. No pneumothorax. Very low lung volumes with increasing bibasilar opacities likely atelectasis. Small right sided effusion. Right-sided port terminates near the cavoatrial junction.	No pneumothorax, interval decrease and left-sided pleural effusion.
	Lung volumes are low secondary crowding of the bronchovascular markings. Superimposed mild pulmonary edema is also possible. Blunting of the left lateral costophrenic angle suggests an effusion. There may also be a small right pleural effusion as well. Left chest wall Port-A-Cath is again noted, catheter tip not clearly delineated but likely in the region of the RA SVC junction.	Low lung volumes and probable bilateral effusions, left larger than right. Superimposed mild edema is also possible.
	An enteric tube terminates in the proximal stomach and could be advanced for appropriate placement. Lungs are markedly low which accentuates bronchovascular markings. Given that, the cardiac silhouette is enlarged. No focal consolidation or pleural effusion. No pneumothorax. There is mild pulmonary vascular engorgement and mild pulmonary edema.	Exam limited by technique. Markedly low lung volumes mild pulmonary edema.
	Compared with earlier the same day, CHF findings may be very slightly improved. Otherwise, no significant change is detected. No pneumothorax identified.	As above.
	A portable frontal chest radiograph demonstrates an enteric tube, with the tip in the stomach. The heart remains mildly enlarged, with decrease in mediastinal caliber. The lungs are moderately inflated. There is no focal consolidation, pulmonary edema, or pneumothorax. The left pleural effusion seen on prior chest radiographs is improved, with only a trace amount of pleural fluid, if any. The visualized upper abdomen is unremarkable.	Interval decrease in a left pleural effusion, with trace pleural fluid, if any. Improvement of pulmonary edema and mediastinal vascular engorgement.
	Portable AP upright chest radiograph obtained. There is bibasilar opacity, likely atelectasis, though a component of aspiration not excluded. No large effusion or pneumothorax. Cardiomediastinal silhouette appears grossly unremarkable aside from an unfolded partially calcified thoracic aorta. No definite bony injuries are seen.	Bibasilar atelectasis, possible mild aspiration. Otherwise, no acute findings.
	Heart size is borderline enlarged. The aorta remains tortuous and diffusely calcified. The hilar contours are stable. Crowding of the bronchovascular structures is likely attributable to low lung volumes. No overt pulmonary edema is seen. Streaky bibasilar airspace opacities are more pronounced on the left rather than right, and may be slightly improved compared to the prior study. No pleural effusion or pneumothorax is demonstrated, and there are no displaced fractures noted.	Bibasilar airspace opacities most likely reflective of atelectasis though aspiration is not excluded. Overall, the aeration of the lung bases is slightly improved compared to the prior exam.
	Interval insertion of bilateral chest tubes, appear low. Heart is moderately enlarged. Mild pulmonary edema unchanged. Most of the abnormalities due to persistence of the pleural effusions and left lower lobe atelectasis. There is no pneumothorax. Atrioventricular pacer leads follow their expected courses, continuous from the left pectoral generator. No pneumothorax.	No pneumothorax. No substantial change in bilateral moderate effusions. Bilateral chest tubes appear low.
	Tip of the enteric tube extends to the proximal fundus of the body, but the sidehole is at the GE junction, and advancement is also recommended. Lungs are hyperinflated, with moderate to severe emphysema. No focal consolidation to suggest pneumonia. Ill-defined opacities are noted in the right upper lobe and left lower lobe, which are of unclear clinical significance. No pleural effusion or pneumothorax. Heart size is normal. There are multiple old bilateral rib fractures.	Recommend advancement of both the endotracheal and enteric tubes. Moderate to severe emphysema. Ill-defined opacities in the right upper and left lower lung, of unclear clinical significance. Close interval follow-up is recommended, with consideration for a repeat PA and lateral chest radiograph if appropriate.
	Enteric tube in right-sided PICC line are similar in position. There are persistent bibasilar opacities without significant interval change since the prior study.	No significant interval change.
	An enteric tube courses below the left hemidiaphragm, into the stomach and tip located off the inferior borders of the film. Heart size remains within normal limits. Mediastinal contours unchanged. Bilateral hilar enlargement compatible with underlying pulmonary arterial hypertension is re- demonstrated. Emphysema is again noted along with patchy airspace opacities within the right mid lung field and both lung bases, unchanged. No pneumothorax or pleural effusion is present. Bilateral rib fractures are unchanged.	Enteric tube in standard position. Unchanged right mid and bibasilar patchy airspace opacities, findings which may reflect atelectasis and/or infection. No pneumothorax.
	The extensive subcutaneous emphysema, pneumomediastinum, and small right apical pneumothorax has marginally decreased since . median sternotomy with stable cardiac and mediastinal contours. Persistent low lung volumes with stable, periphery parenchymal opacities in both lungs due to pulmonary fibrosis. Bibasilar atelectasis unchanged since . Right internal jugular Port-A-Cath unchanged in position. No pulmonary edema.	Minimal interval decrease in the extensive subcutaneous emphysema when compared to
	A single portable frontal view of the chest was performed. There is no pleural effusion, pneumothorax or focal airspace consolidation. The cardiac and mediastinal contours are normal. The hilar structures and pleural surfaces are unremarkable. There are no acute osseous abnormalities appreciated.	No acute cardiopulmonary process.
	The lungs appear hyperexpanded. No focal consolidation, pleural effusion or pneumothorax identified. The size of the cardiac silhouette is within normal limits.	Hyperexpanded lungs. No radiographic evidence of acute cardiopulmonary disease.
	Single portable view of the chest. The lungs are clear consolidation or large effusion. The trachea is mildly deviated to the left at the thoracic inlet raising possibility of underlying thyroid enlargement on the right. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected.	No acute cardiopulmonary process. Slight leftward deviation of the trachea at the thoracic inlet. Could repeat exam with PA and lateral technique to optimize positioning versus consider thyroid ultrasound.
	There has been slight interval retraction of a right-sided chest tube which now projects over the mid right lung field. The inferior chest tube projects over the lower lung. Right-sided subcutaneous emphysema persists. Small right apical pneumothorax is unchanged. Large known upper lobe consolidation on the right appears similar to the prior exam with persistent mild right basilar atelectasis. Mild plate-like atelectasis is seen at the left lung base; otherwise, the left lung is clear. There is no interval change in the appearance of the cardiac silhouette. Small right-sided pleural effusion is persistent. The visualized osseous structures are unremarkable.	Unchanged small right apical pneumothorax with persistent right basilar atelectasis. Persistent small right pleural effusion.
	An enteric tube is seen courseing below the diaphragm, terminating in the proximal stomach. There is prominence of the right hilum with suggestion of retraction seen. There is also opacity projecting over the right lung apex, as was also the case on the prior study. There appears to be volume loss in the right lung with elevation of the right hemidiaphragm as well. Areas of opacity in the right mid to lower lung appear somewhat increased and there is suggestion of right perihilar air bronchograms. There is slight blunting of the right costophrenic angle, which may be due to trace effusion or pleural thickening. The left lung is clear. No pneumothorax is seen. The cardiac silhouette is mildly enlarged.	Volume loss on the right hemithorax. Right pleural effusion. Increased opacities in the right mid to lower lung, with air bronchograms may be due infection and/or worsening of malignant disease.
	Overall, two right-sided chest tubes are similar in position compared to the prior exam. Small right apical pneumothorax is unchanged. There has been slight interval improvement in the extent of the right subcutaneous emphysema. Large known upper lobe consolidation on the right appears similar to the prior exam with an interval increase in right lung base atelectasis. The left lung is clear aside from plate-like areas of atelectasis at the left lung base. There is no interval change in the appearance of the cardiac silhouette. There may be a small right-sided pleural effusion.	Unchanged small right apical pneumothorax with interval increase in right basilar atelectasis.
	The cardiac, mediastinal and hilar contours appear stable. Patchy retrocardiac opacity appears streaky and probably due to atelectasis. Otherwise the lungs appear clear. There are no pleural effusions or pneumothorax.	Mild retrocardiac opacification, most commonly due to atelectasis also although not entirely specific.
	NG tube tip is off the film, at least in the stomach. There is volume loss/ consolidation at both bases. Heart size is upper limits of normal.	The bilateral lower lobe volume loss/infiltrate
	Single AP view of the chest. No prior. The lungs are clear of consolidation, vascular congestion or effusion. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures demonstrate no acute abnormality.	No acute cardiopulmonary process.
	Portable chest radiograph demonstrates apparent widening of mediastinum this is due to patient rotation. Cardiomediastinal and hilar contours are unremarkable. Low lung volumes with vascular crowding. Lungs are clear. No pleural effusion or pneumothorax.	No acute intrathoracic process.
	Heart is upper limits of normal in size and accompanied by mild pulmonary vascular congestion and small right pleural effusion. Bibasilar platelike atelectasis is slightly improved. There is no pneumothorax or focal consolidation. The cardiomediastinal silhouette is stable. The left-sided Bochdalek's hernia is unchanged. Impression on the right aspect of the trachea may be related to an enlarged thyroid gland.	No evidence of pneumonia.
	A left chest wall port catheter tip terminates at the cavoatrial junction. The lungs are well expanded. There are worsening confluent basilar opacities, right greater than left with new patchy opacities in the right upper lobe. Diffuse ground glass and linear opacities have also progressed since the prior radiograph. Small bilateral pleural effusions are new. There is no pneumothorax. The cardiomediastinal silhouette is normal. The bones are intact.	Worsening multifocal opacities most confluent at the lung bases are concerning for worsening atypical infection and less likely asymetric pulmonary edema or hemorrhage.
	Mild enlargement of the cardiac silhouette is present. The aortic knob is calcified. Mediastinal contours unremarkable. There is mild pulmonary edema along with small bilateral pleural effusions. Elevation the right hemidiaphragm is of unknown chronicity. Patchy opacities in lung bases may reflect areas of atelectasis. No pneumothorax is present. There are no acute osseous abnormalities demonstrated.	Mild pulmonary edema with small bilateral pleural effusions and bibasilar patchy opacities, likely atelectasis.
	NG tube tip is seen in the stomach. A left-sided subclavian line ends in the mid SVC. A PICC is seen ending in the atriocaval junction. The lungs are otherwise clear of focal opacities. Heart size is normal. No obvious pleural effusions or pneumothoraces are seen. No pulmonary edema is present.	No acute cardiopulmonary process. Lines in position as above.
	Lung volumes are low, accounting for bronchovascular crowding. There is no focal opacity concerning for pneumonia. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax.	Low lung volumes. No evidence of acute cardiopulmonary process.
	There has been interval decrease in the size of the right pleural effusion status post drainage. There is a new small right apical pneumothorax. A nasogastric feeding tube courses below the hemidiaphragm, tip not visualized. Mild pulmonary edema is unchanged. Small left pleural effusion with associated left lower lobe atelectasis are unchanged. Surgical skin and metallic hardware in the cervical region are unchanged.	Status post drainage of right pleural effusion which is now small. New small right apical pneumothorax. Stable mild pulmonary edema, left lower lobe atelectasis and small left pleural effusion. with Dr.
	The enteric tube courses below the hemidiaphragm, tip not visualized. Moderate right and small left pleural effusions are unchanged. Mild cardiomegaly despite the projection is unchanged. There is slightly increased pulmonary vascular congestion, and new obscuration of the left hemidiaphragm, which is most likely due to atelectasis. A tiny left apical pneumothorax shows no appreciable change. The patient has had previous cervical spine fusion.	New left lower lobe atelectasis. Slightly increased pulmonary vascular congestion. Stable tiny left apical pneumothorax.
	The nasogastric tube enters the right main bronchus and extends well into the right bronchial tree. There is no pneumothorax. Mild pulmonary edema with moderate bilateral pleural effusions are unchanged. Moderate cardiomegaly despite the projection is also unchanged. Coarse vascular calcifications are incidentally noted. The patient has had prior cervical spine fusion.	Malpositioned NG tube enters the right main bronchus to terminate in the distal bronchial tree. Repositioning is advised. No other appreciable interval change.
	Portable AP upright chest radiograph is obtained. The lungs appear clear bilaterally without focal consolidation, effusion, or pneumothorax. A left fifth rib fracture seen on CT is not evident on this chest radiograph. Cardiomediastinal silhouette appears normal.	No acute findings. Please refer to CT chest from outside hospital for further details.
	The heart is normal in size. There is mild unfolding of the thoracic aorta. The mediastinal and hilar contours appear unchanged. The lungs appear clear. A nipple shadow is visualized on the left. A deformity of the left proximal humerus appears similar allowing for differences in technique. There is mild leftward convex curvature centered along the lower thoracic spine.	No evidence of acute disease.
	Enteric tube tip in the mid stomach. Right Port-A-Cath tip near cavoatrial junction. Postoperative changes in the upper abdomen with drains, , IVC filter in place. Lungs are clear. Normal heart size, pulmonary vascularity. No effusion. No pneumothorax.	Postoperative changes. No acute cardiopulmonary changes.
	The heart is again mildly enlarged but difficult to visualize on this film in its entirety. The aortic arch is again calcified. The lung volumes are low. Patchy perihilar opacification with indistinct pulmonary vascularity suggests mild vascular congestion or fluid overload. Otherwise, the examination is limited. It is difficult to exclude pleural effusions. There is no pneumothorax. Similar moderate relative elevation of the right hemidiaphragm is noted. Prominent lucency beneath the right hemidiaphragm appears very similar and is likely to reflect colonic interposition noting that the appearance is basically unchanged. There is a mildly prominent gas distended segment of bowel projecting over the right upper quadrant, potentially small bowel.	Findings suggesting mild vascular congestion. Similar elevation of the right hemidiaphragm with lucency compatible with colonic interposition, noting lack of change. However, clinical correlation is suggested. There is also mildly dilated segment of probable small bowel projecting over the right upper quadrant of the abdomen. Correlation with abdominal symptoms, if any, is recommended.
	Persistent mild-to-moderate pulmonary vascular congestion; however, pulmonary edema is improved asymmetrically better on the right. Mediastinal silhouette remains stably at the upper limits of normal. Calcifications are noted at the aortic arch. Colonic interposition is again noted. Osseous structures remain normal.	Continued mild-to-moderate vascular congestion. However, pulmonary edema has improved asymmetrically better on the right.
	Portable AP chest radiograph. Right basilar pleural pigtail is curled within the periphery of the right hemithorax with interval decrease in size of basal component of the loculated right pleural effusion. The more superior portion persists unchanged. Improved basilar aeration is noted. The left lung is clear. No pneumothorax is seen. Heart and mediastinal contours are unremarkable.	Status post placement of right basal pleural catheter located in the peripheral right hemithorax with decrease in the right basal component of the pleural effusion without pneumothorax.
	An enteric tube side port projects over the mid stomach. No other significant changes are appreciated. Right upper lung and perihilar opacification is similar, probably a combination of known lung cancer with postobstructive pneumonia. Substantial emphysematous changes are stable bilaterally.	Unchanged appearance of right upper lobe opacities concerning for postobstructive pneumonia.
	Similar to scout image from , there is large area of opacity in the right upper hemi thorax in right perihilar region concerning for postobstructive pneumonia secondary to known large juxta hilar mass. The left lung remains hyperinflated. No large pleural effusion is seen. There is no evidence of pneumothorax. The cardiac and mediastinal silhouettes are unremarkable.	Large area of right upper hemi thorax and right juxta hilar opacity, grossly similar in distribution as compared to the prior CT, although with possibly slightly more fluid in the right lung apex, overall worrisome for postobstructive pneumonia secondary to right juxta hilar mass. Reported right chest wall metastasis on prior CT better assessed on CT.
	Cardiac, mediastinal and hilar contours are within normal limits. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormality is visualized.	No acute cardiopulmonary abnormality.
	AP upright portable chest radiograph is obtained. There is no evidence of free air below the right hemidiaphragm. The lungs appear clear bilaterally. Cardiomediastinal silhouette is normal. Bones appear intact.	No acute findings including no sign of pneumoperitoneum.
	The AP view of the chest. The lungs are clear of confluent consolidation. Biapical scarring is again seen. Linear opacity at the left lung base most suggestive of atelectasis. Cardiomediastinal silhouette is within normal limits. Surgical clips seen in the left upper quadrant. There is no free intraperitoneal air. No acute osseous abnormality detected.	No acute cardiopulmonary process, no free intraperitoneal air.
	The lungs are clear without focal infiltrate. There are minimal bilateral pleural effusions. The heart is upper limits normal in size. Aorta is mildly tortuous. There is apical pleural thickening.	No focal infiltrate.
	Lung volumes are low on the right without convincing evidence of lobar atelectasis. There are multiple right-sided rib deformities consistent with old rib fractures. No pneumothorax. There is mild prominence of the bilateral hila and pulmonary vasculature consistent with a mild degree of congestive heart failure but no frank pulmonary edema. Mild cardiomegaly may be exaggerated by the projection. No consolidation or pleural effusion seen.	No frank pulmonary edema seen.
	Left-sided Port-A-Cath terminates in the low SVC. New dense left lower lobe and lower under consolidation can be pneumonia and/or aspiration. There is likely adjacent pleural fluid. The right lung is clear. Heart size is normal. No pneumothorax.	New dense consolidation in the left lower lobe with associated moderate effusion can be pneumonia.
	The lungs are clear with no focal opacities. There is some minimal bibasilar atelectasis. The cardiomediastinal silhouette and hilar contours are normal. The pleural surfaces are clear without effusion or pneumothorax. The left chest wall pacing device and pacer leads are unchanged in appearance.	No evidence of acute cardiopulmonary process.
	There has been interval removal of the ET tube, Swan-Ganz catheter, chest tube, mediastinal drains, and NG tube. There is volume loss in both lower lungs. The heart is mildly enlarged. Sternal wires and mediastinal clips are again seen. There is minimal pulmonary vascular redistribution. There is no pneumothorax.	No pneumothorax post chest tube removal.
	AP portable upright view of the chest. Overlying EKG leads are present somewhat limiting assessment. The heart appears top-normal in size. Interstitial opacities are noted bilaterally which could reflect chronic lung disease i. e. fibrosis and/or interstitial pulmonary edema. Please correlate clinically. No large effusion or pneumothorax. No focal opacity concerning for pneumonia. Bony structures are intact	Interstitial opacities noted bilaterally which could reflect chronic lung disease and/or pulmonary interstitial edema. Please correlate clinically.
	Dual lead left-sided pacer device is stable in position. The cardiac and mediastinal silhouettes are stable. No focal consolidation is seen. There is no pleural effusion or pneumothorax. No pulmonary edema is seen.	Stable position of the left ICD. No pulmonary edema.
	Right chest wall port is seen with catheter tip at the RA SVC junction. There is a moderate right-sided pneumothorax which is new from prior. There is no definite signs of tension. Linear opacity at the left lung base is likely atelectasis. The lungs are otherwise clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. Subcutaneous gas projects over the right axilla.	New moderate right sided pneumothorax.
	Heart size in cardia mediastinal silhouettes are unchanged. Lungs are fully expanded and clear without focal consolidation. No pleural effusions or pneumothorax.	Interval removal of pericardial drain, otherwise no significant changes. If concerned about pericardial effusion, echocardiogram is recommended.
	m. and allowing for technical differences, no definite change is identified. Again seen is patchy opacity in the right infrahilar region and at the left base (previous chest x-ray suggested in the left lower lobe). Cardiomediastinal silhouette is unchanged. There is upper zone redistribution, without overt CHF. No new focal opacity is detected. No pneumothorax is identified. Densities in the upper abdomen likely relate to prior embolization.	Allowing for technical differences, doubt significant interval change compared with earlier the same day. Again noted (but better seen on the most recent prior study), are non-specific patchy opacities in the right middle and left lower lobes. Chest CT is recommended for further assessment of these opacities and for evaluation of the apparent interval increase in the size of the mediastinum compared with .
	ETT in standard position. Enteric feeding tube traverses the midline and ends in the left upper quadrant, unchanged. Atelectasis of the left lung base is mild. Otherwise, the lungs are clear. No focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The heart is normal in size. The mediastinum is not widened. The hila are unremarkable.	ETT in standard position.
	There are relatively low lung volumes. Large opacity projecting over the left mid to lower lung fields with subtle air bronchograms seen is worrisome for pneumonia. No definite pleural effusion is seen, although small left pleural effusion is difficult to exclude. The right lung is clear. There is no pneumothorax. The cardiac and mediastinal silhouettes are unremarkable.	Large left lower lobe consolidation worrisome for pneumonia.
	Lung volumes are low. Heart size is normal. Mediastinal contours are unremarkable, though the superior mediastinum is not well assessed as the patient's chin obscures this region. Tracheostomy tube is in unchanged position. Hilar contours are normal. There is no pulmonary edema. Minimal blunting of the left costophrenic angle may suggest a small pleural effusion. Retrocardiac patchy opacity and minimal right basilar opacity likely reflect atelectasis. No pneumothorax is identified but the apices are not well assessed due to the patient's chin and soft tissues of the neck obscuring these regions. There is no acute osseous abnormality.	Limited assessment. Bibasilar patchy opacities likely reflect atelectasis in the setting of low lung volumes, but infection or aspiration cannot be excluded completely.
	There is a small right-sided pneumothorax with a chest tube traversing medially and terminating along the right mediastinal border. The heart size is mildly enlarged. There is mild pulmonary vascular congestion. Note is made of subcutaneous emphysema along the right lateral chest wall. Increased opacities at the mid right lung, is likely secondary to aspiration. No acute fracture is identified. The left lung aside from mild pulmonary vascular congestion is otherwise clear. There is no large pleural effusion.	Chest tube in appropriate position with small right-sided pneumothorax. Increased opacities at the mid right lung is likely secondary to aspiration. Continued close interval follow up is recommended.
	Orogastric tube tip courses below the diaphragm, off the inferior borders of the film. The heart size is normal. The mediastinal and hilar contours are unremarkable. The lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormality seen.	Endotracheal tube and orogastric tube in standard positions. No acute cardiopulmonary abnormality.
	Portable frontal upright radiograph of the chest. Lower lung volumes are noted. Mild enlargement of the cardiac silhouette is again noted, perhaps slightly smaller than on prior study. No focal consolidation, pleural effusion or pneumothorax is present. Vascularity is within normal limits.	No evidence of pneumonia.
	AP portable upright view of the chest. Patient is slightly leftward rotated. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air is seen below the right hemidiaphragm.	No acute intrathoracic process. No signs of pneumoperitoneum.
	Allowing for technical differences, the parenchymal findings are similar, possibly slightly worse. No effusions are identified. ET tube and NG tube are similar. The cardiomediastinal silhouette is probably unchanged.	Radiopaque portion of aortic balloon pump now lies slightly higher. Clinical correlation regarding retraction is requested. Diffuse alveolar opacities, with relative sparing of lung bases, are similar, possibly slightly worse.
	Compared to the prior film, the tip of the aortic balloon pump appears to lie higher. Though the aortic knob is not well delineated, it appears to lie at the top of the expected location of the aortic knob. NG tube, beneath the diaphragm, with tip overlying fundus. Catheter from an inferior approach, question Swan-Ganz catheter, with tip overlying the region of the main pulmonary artery. Compared to the prior study, there may have been slight leftward shift of the mediastinum. Again seen are diffuse patchy opacities throughout both lungs, most pronounced in the upper zones, with relative sparing of the lower zones. Density of the left upper zone is more confluent than on the prior study. There are not fully characterized, but could represent an atypical distribution of CHF with pulmonary edema or other alveolar infiltrates.	Positioning of aortic balloon pump is thought to be high- see comments above. Possible slight interval leftward shift of the mediastinum, suggesting the presence of some volume loss on the left. Dense, somewhat patchy, bilateral alveolar infiltrates, with upper zone predominance. This is not fully characterized. In the appropriate clinical setting, this could represent atypical distribution of pulmonary edema, ARDS, or other causes of alveolar infiltrates. Possibility of a component pleural fluid or apical capping cannot be excluded. If clinically indicated, chest CT may help for more complete characterization.
	Slightly rotated positioning. An NG tube an NG type tube is present, tip overlying the gastric fundus, beneath the diaphragm. An IABP is present, extending from an inferior approach. The aortic knob itself is not well-defined, but the radiopaque tip probably lies at or immediately below the lower edge of the aortic knob. There are dense, confluent opacities in both upper zones, extending into the mid/ lower zones, but with sparing of both lung bases. The degree of confluence is greater on the left. No effusion is identified. Cardiomediastinal silhouette is at the upper limits of normal, but not frankly enlarged. No pneumothorax is detected.	ET and NG tubes, as described. IABP radiopaque tip probably lies at or immediately below the inferior edge of the aortic knob. Dense left-greater-than-right opacities, with upper lobe predominance and sparing of the bases. While this could represent an atypical distribution of CHF, including changes associated with valve dysfunction, in the appropriate clinical setting, the upper lobe predominance would also raise the question of infectious or inflammatory etiologies.
	AP single view of the chest has been obtained with patient in sitting semi-upright position. Comparison is made with the next preceding similar study obtained four hours earlier during the same day. Again identified is status post right upper lobectomy with moderately elevated right-sided diaphragm and local chest wall emphysema in the right shoulder area. No pneumothorax has developed since the preceding study, and no new infiltrates are seen.	Stable chest findings as seen on portable followup examination, status post right upper lobectomy.
	Single AP upright portable view of the chest was obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are stable and unremarkable with calcifications at the aortic knob. No evidence of free air is seen beneath the diaphragms. The right paratracheal opacity is stable since the prior study.	No acute cardiopulmonary process. No evidence of free air beneath the diaphragms.
	Patient is status post coronary artery bypass graft surgery. The cardiac, mediastinal and hilar contours appear unchanged including moderate cardiomegaly. What is new is bilateral opacification of each lung base, which is especially confluent in the retrocardiac region on the left. Particularly on the right, small coinciding pleural effusion is suspected. Indistinct pulmonary vasculature appears mildly distended suggesting coinciding vascular congestion.	Substantial opacities at both lung bases, raising concern for pneumonia. Findings also suggest mild coinciding vascular congestion and possibly small pleural effusions.
	AP portable supine view of the chest. Underlying trauma board is in place. Lungs appear clear. No supine evidence of effusion or pneumothorax. The cardiomediastinal silhouette appears grossly within normal limits. No acute bony injury.	Limited, negative.
	The heart size is normal. The mediastinal and hilar contours are unchanged. The pulmonary vasculature is not engorged. Persistent crescentic focal opacity is noted within the left lower lobe, which could reflect an area of infection or atelectasis. Minimal streaky opacities elsewhere in both lung bases are compatible with areas of atelectasis. No pleural effusion or pneumothorax is seen. Mild paraseptal emphysematous changes are noted in the lung apices. There are no acute osseous abnormalities.	Persistent crescentic area of opacification within the left lower lobe which may reflect an area of infection or atelectasis.
	Since the prior CXR, there has been interval placement of an enteric tube that terminates in the stomach, but the sidehole is at the GE junction. The right sided PICC line has been advanced and now terminates in the mid right atrium. There has been interval worsening of the right layering pleural effusion and adjacent atelectasis. No left pleural effusion. No pneumothorax. Heart size is top normal. Mediastinum appears widened, likely due to patient rotation. Cervical fusion device is unchanged in location.	Interval advancement of the right PICC line, which now terminates in the right atrium. Worsening layering right effusion. by Dr.
	There has been interval increase in the right pleural effusion is layering posteriorly. There content there continues to be dense retrocardiac opacification that has increased in the interval. There is probably a small left effusion as well. NG tube tip is off the film, at least in the stomach. Right-sided PICC line tip is at the cavoatrial junction	Worsened fluid status.

Supine and portable AP view of the chest was provided. There has also been placement of an NG tube with its tip in the left upper quadrant, likely in the stomach. Otherwise no change.

NGT position in appropriate position.

Single portable view of the chest. Somewhat ill-defined interstitial markings seen throughout the lungs. There is no confluent consolidation. Cardiac silhouette is enlarged but likely in part accentuated by technique. Atherosclerotic calcifications noted at the aortic arch. Left chest wall dual-lead pacing device is identified.

Increased markings throughout the lungs which could be chronic, although superimposed interstitial edema is also suspected.

Mild cardiomegaly is stable. Mediastinal and hilar contour is are also stable. There is no pleural effusion or pneumothorax. The lungs are expanded without focal consolidation concerning adenoma. Pulmonary vasculature is within normal limits. The upper abdomen is unremarkable. Dual lead pacemaker is noted with leads terminating in the right atrium and right ventricle as expected.

No acute cardiopulmonary process.

Motion limits detailed evaluation. There is faint left basilar opacity potentially atelectasis. Elsewhere the lungs are grossly clear. The cardiomediastinal silhouette is stable. No acute osseous abnormalities.

Probable left basilar atelectasis. Otherwise, no definite acute cardiopulmonary process.

There is moderate cardiomegaly that is increased compared to prior and bilateral pleural effusions that are also larger. There is a right IJ line with tip in the upper SVC. There is volume loss in both lower lungs.

Worsened fluid status.

The heart size is normal. The mediastinal and hilar contours are unremarkable. Lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is identified. There are no acute osseous abnormalities. Marked degenerative changes of the left glenohumeral joint are visualized with subchondral cysts and sclerosis.

No acute cardiopulmonary abnormality.

Assessment is somewhat limited due to patient rotation and kyphosis. Lung volumes are low. Heart size is mildly enlarged. The aorta remains tortuous. Perihilar hazy opacities with vascular indistinctness is more pronounced on the right compared to the left, likely reflective of asymmetric mild to moderate pulmonary edema. No pneumothorax is demonstrated. Small right pleural effusion is likely present. No acute osseous abnormalities are seen.

Perihilar hazy opacities and vascular indistinctness, more pronounced on the right compared to the left likely reflects asymmetric mild to moderate pulmonary edema. Probable small right pleural effusion.

There is near complete opacification of the left hemithorax likely reflective of a combination of large pleural effusion and atelectasis. Heart size cannot be assessed due to the presence of the left hemithorax opacification. Dense atherosclerotic calcifications of the thoracic aorta are present. No pulmonary vascular congestion is seen. The right lung is grossly clear. No pneumothorax is noted. No acute osseous abnormalities are visualized.

Near-complete opacification of the left hemithorax likely due to a combination of a large left pleural effusion and atelectasis. CT of the chest is recommended to exclude an obstructing central endobronchial lesion.

A right-sided PICC terminates at the cavoatrial junction without evidence of pneumothorax. There are low lung volumes. No new focal consolidation is seen. There is no large pleural effusion. Prominence of the right hilum is grossly stable.

Right-sided PICC now terminates at the cavoatrial junction. No evidence of pneumothorax.

The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. Atherosclerotic calcifications are noted of the aortic arch. The lungs are mildly hyperexpanded but clear. There is no definite pleural effusion or pneumothorax, though evaluation is limited on this supine examination.

No acute intrathoracic process.

The cardiomediastinal silhouette and pulmonary vasculature are unremarkable. Lungs are clear. There is no pleural effusion or pneumothorax.

No acute intrathoracic process.

There are no lung opacities concerning for pneumonia. Both pleural spaces are normal. Heart size is normal, mediastinal and hilar contours are unremarkable.

No pneumonia.

There is no appreciable pneumothorax. A right IJ central venous catheter terminates in the upper right atrium. A nasogastric tube enters the stomach, tip not visualized. Small layering pleural effusions with bibasilar subsegmental atelectasis are unchanged. The heart and mediastinum are within normal limits despite the projection. A third radiopaque tube projects over the add line cervical soft tissues, terminates at the level of the first rib. If there is a second intended device, it ends in the neck.

Stable small bilateral layering pleural effusions with bibasilar subsegmental atelectasis. with Dr.

Right-sided dual lumen central venous catheter tip terminates in the proximal right atrium, unchanged. The cardiac, mediastinal and hilar contours are unchanged and within normal limits. The pulmonary vasculature is normal. Lungs are clear. No pleural effusion or pneumothorax is present. No acute osseous abnormalities are visualized. No subdiaphragmatic free air is seen.

No acute cardiopulmonary abnormality. No subdiaphragmatic free air is visualized.

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

No change.

There continues to be compressive changes at the right base. There continues to be retrocardiac opacity. There is mild pulmonary vascular redistribution. There is no pneumothorax. .

No change.

Single AP upright portable view of the chest was obtained. The cardiac silhouette remains mildly enlarged. Mediastinal contours are stable, as are hilar contours. No focal consolidation, pleural effusion or evidence of pneumothorax is seen. There is no overt pulmonary edema. Costochondral calcifications are seen.

Persistent mild enlargement of the cardiac silhouette. No overt pulmonary edema.

The left lung base is densely opacified by a combination of pleural effusion and lower lobe collapse. Heterogeneous density in the right lower hemithorax is also likely a combination of pleural effusion and atelectasis. A large area of vaguely increased radiodensity in the right upper lobe is probably consolidation. Heart size is top-normal. There is no pneumothorax.

Left pleural effusion and lower lobe collapse. Smaller right pleural effusion and less severe atelectasis. Right upper pneumonia.

There are moderate bilateral pleural effusions with volume loss/infiltrate in both lower lungs. There is mild pulmonary vascular redistribution. The heart size is mildly enlarged. The aorta is calcified and tortuous. Spine demonstrates a mild scoliosis and degenerative changes.

CHF. An underlying infectious infiltrate cannot be excluded.

Portable chest radiograph demonstrates interval development of moderate pulmonary edema as demonstrated by increased interstitial fluid and central vascular congestion. Mild cardiomegaly is unchanged. Small bilateral pleural effusions are increased in size. There is no pneumothorax. An old left healed clavicular fracture is once again identified.

Interval development of moderate pulmonary edema.

Portable chest radiograph demonstrates improved vascular plethora and decreased interstitial fluid consistent with overall improved pulmonary edema. Bilateral small pleural effusions are mildly increased in size. Mild cardiomegaly is unchanged. The right minimally enlarged hila is unchanged. Redemonstration of old left healed clavicular fracture.

Improved pulmonary edema with stable mild cardiomegaly.

The previously noted linear opacities in the bases bilaterally have improved. There are no other new opacities. Heart size is stable. The mediastinal and hilar contours are stable. The pulmonary vasculature is normal. No pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.

Improvement in prior linear opacities in the bases bilaterally, with almost complete resolution.

The aortic contour and calcification pattern appears similar compared to prior studies. Descending thoracic aortic contour also appears similar to prior studies, but is obscured inferiorly by adjacent lung and pleural abnormalities. Cardiac silhouette remains enlarged, and is accompanied by upper zone vascular redistribution. Small-to-moderate bilateral pleural effusions are present as well as adjacent basilar atelectasis and/or consolidation, worse on the right than the left. ICD pacing device remains in place with leads in the right atrium and right ventricle.

No portable chest radiographic findings to suggest aortic dissection, but the sensitivity of this study is low for detecting this diagnosis. If there is clinical suspicion for acute aortic dissection, a CT angiogram would be recommended.

A portable frontal chest radiograph demonstrates a normal cardiomediastinal silhouette and hyperinflated lungs compatible with emphysema. No focal consolidation, pleural effusion, or pneumothorax. No displaced rib fracture is identified. The visualized upper abdomen is unremarkable.

No displaced rib fracture identified. If there is continued concern, dedicated rib radiographs can be obtained. Hyperinflated lungs, consistent with known emphysema.

AP portable upright view of the chest provided. The bilateral pulmonary hila appear symmetrically prominent which is of unclear etiology though could reflect the presence of lymphadenopathy. Consider dedicated PA and lateral views to further assess. Aside from this, the lungs are clear. The heart size is normal. Mediastinal contour is stable. No pneumothorax or effusion is seen. Bony structures are intact.

Bilateral hilar prominence which could be better assessed with a dedicated PA and lateral view of the chest. Otherwise, unremarkable.

The enteric tube courses beyond the diaphragm, terminating in the left upper quadrant, likely in the region of the stomach. The lungs are relatively well inflated with obscuration of the costophrenic angles bilaterally, likely a combination of pleural fluid and atelectasis. Heart size is within normal limits and the cardiomediastinal contour is normal. Exuberant costochondral calcifications are noted bilaterally.

Satisfactory position of endotracheal and enteric tubes.

Extensive diffuse airspace opacities are slightly worse than on , progressively worsening since , accentuated by lower lung volumes. A right PICC terminates in the mid SVC, unchanged. No pneumothorax. Stable mild cardiomegaly. No larger pleural effusions.

Slightly worse extensive airspace opacities since , progressively worsening since , concerning for multifocal infection or severe pulmonary edema.

Single supine AP portable view of the chest was obtained. A right internal jugular central venous catheter is seen terminating in the low SVC without evidence of pneumothorax. There are prominent right greater than left perihilar opacities. No large pleural effusion is seen, although a trace right pleural effusion would be difficult to exclude. Cardiac silhouette is top normal. Mediastinal contours are unremarkable.

Right internal jugular central venous catheter terminates in the low SVC without evidence of pneumothorax. Right greater than left perihilar opacities may be due to infection vs asymmetric pulmonary edema, other alveolar process not excluded.

Lung volumes remain low, slightly worse from the prior exam. Opacification in the right lung base with increased rightward shift of the mediastinum loss of the right hemidiaphragm and right heart border interval increase in atelectasis as well as a moderate right pleural effusion that has progressed despite the presence of a drain projecting over the right hemithorax. Small left pleural effusion and is overall unchanged. Unchanged retrocardiac opacity. Moderate edema is worse from the prior exam. A left PICC line is appropriately placed.

Progressive edema and re-accumulation of right pleural effusion despite drain, now moderate in size.

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

No change.

The tip of a left subclavian line overlies the distal SVC. No pneumothorax detected. There are bilateral effusions, with underlying collapse and/or consolidation. There is upper zone redistribution and diffuse vascular blurring, consistent with CHF. The cardiomediastinal silhouette, including prominence of the SVC, is enlarged, but unchanged.

CHF, with bibasilar effusions and underlying collapse and/or consolidation. The possibility of an underlying infectious infiltrate cannot be excluded.

Tracheostomy tube appears midline and intact. Enteric tube traverses the diaphragm. Right PICC line ends in the low SVC, unchanged. Pigtail catheter projects over the right lower hemithorax and appears intact but its orientation has changed. Lung volumes remain low, but slightly improved from the prior exam. The right pleural effusion has slightly decreased in size, now small. Left pleural effusion, if present, is small. No pneumothorax.

Minimal interval improvement in aeration and decrease in size of small right pleural effusion. Interval change in orientation of right pigtail catheter - correlate with clinical assessment.

As compared to chest radiograph from earlier today, interval thoracentesis with significant decrease an left-sided effusion which is now small to moderate. No pneumothorax. Very low lung volumes with increasing bibasilar opacities likely atelectasis. Small right sided effusion. Right-sided port terminates near the cavoatrial junction.

No pneumothorax, interval decrease and left-sided pleural effusion.

Lung volumes are low secondary crowding of the bronchovascular markings. Superimposed mild pulmonary edema is also possible. Blunting of the left lateral costophrenic angle suggests an effusion. There may also be a small right pleural effusion as well. Left chest wall Port-A-Cath is again noted, catheter tip not clearly delineated but likely in the region of the RA SVC junction.

Low lung volumes and probable bilateral effusions, left larger than right. Superimposed mild edema is also possible.

An enteric tube terminates in the proximal stomach and could be advanced for appropriate placement. Lungs are markedly low which accentuates bronchovascular markings. Given that, the cardiac silhouette is enlarged. No focal consolidation or pleural effusion. No pneumothorax. There is mild pulmonary vascular engorgement and mild pulmonary edema.

Exam limited by technique. Markedly low lung volumes mild pulmonary edema.

Compared with earlier the same day, CHF findings may be very slightly improved. Otherwise, no significant change is detected. No pneumothorax identified.

As above.

A portable frontal chest radiograph demonstrates an enteric tube, with the tip in the stomach. The heart remains mildly enlarged, with decrease in mediastinal caliber. The lungs are moderately inflated. There is no focal consolidation, pulmonary edema, or pneumothorax. The left pleural effusion seen on prior chest radiographs is improved, with only a trace amount of pleural fluid, if any. The visualized upper abdomen is unremarkable.

Interval decrease in a left pleural effusion, with trace pleural fluid, if any. Improvement of pulmonary edema and mediastinal vascular engorgement.

Portable AP upright chest radiograph obtained. There is bibasilar opacity, likely atelectasis, though a component of aspiration not excluded. No large effusion or pneumothorax. Cardiomediastinal silhouette appears grossly unremarkable aside from an unfolded partially calcified thoracic aorta. No definite bony injuries are seen.

Bibasilar atelectasis, possible mild aspiration. Otherwise, no acute findings.

Heart size is borderline enlarged. The aorta remains tortuous and diffusely calcified. The hilar contours are stable. Crowding of the bronchovascular structures is likely attributable to low lung volumes. No overt pulmonary edema is seen. Streaky bibasilar airspace opacities are more pronounced on the left rather than right, and may be slightly improved compared to the prior study. No pleural effusion or pneumothorax is demonstrated, and there are no displaced fractures noted.

Bibasilar airspace opacities most likely reflective of atelectasis though aspiration is not excluded. Overall, the aeration of the lung bases is slightly improved compared to the prior exam.

Interval insertion of bilateral chest tubes, appear low. Heart is moderately enlarged. Mild pulmonary edema unchanged. Most of the abnormalities due to persistence of the pleural effusions and left lower lobe atelectasis. There is no pneumothorax. Atrioventricular pacer leads follow their expected courses, continuous from the left pectoral generator. No pneumothorax.

No pneumothorax. No substantial change in bilateral moderate effusions. Bilateral chest tubes appear low.

Tip of the enteric tube extends to the proximal fundus of the body, but the sidehole is at the GE junction, and advancement is also recommended. Lungs are hyperinflated, with moderate to severe emphysema. No focal consolidation to suggest pneumonia. Ill-defined opacities are noted in the right upper lobe and left lower lobe, which are of unclear clinical significance. No pleural effusion or pneumothorax. Heart size is normal. There are multiple old bilateral rib fractures.

Recommend advancement of both the endotracheal and enteric tubes. Moderate to severe emphysema. Ill-defined opacities in the right upper and left lower lung, of unclear clinical significance. Close interval follow-up is recommended, with consideration for a repeat PA and lateral chest radiograph if appropriate.

Enteric tube in right-sided PICC line are similar in position. There are persistent bibasilar opacities without significant interval change since the prior study.

No significant interval change.

An enteric tube courses below the left hemidiaphragm, into the stomach and tip located off the inferior borders of the film. Heart size remains within normal limits. Mediastinal contours unchanged. Bilateral hilar enlargement compatible with underlying pulmonary arterial hypertension is re- demonstrated. Emphysema is again noted along with patchy airspace opacities within the right mid lung field and both lung bases, unchanged. No pneumothorax or pleural effusion is present. Bilateral rib fractures are unchanged.

Enteric tube in standard position. Unchanged right mid and bibasilar patchy airspace opacities, findings which may reflect atelectasis and/or infection. No pneumothorax.

The extensive subcutaneous emphysema, pneumomediastinum, and small right apical pneumothorax has marginally decreased since . median sternotomy with stable cardiac and mediastinal contours. Persistent low lung volumes with stable, periphery parenchymal opacities in both lungs due to pulmonary fibrosis. Bibasilar atelectasis unchanged since . Right internal jugular Port-A-Cath unchanged in position. No pulmonary edema.

Minimal interval decrease in the extensive subcutaneous emphysema when compared to

A single portable frontal view of the chest was performed. There is no pleural effusion, pneumothorax or focal airspace consolidation. The cardiac and mediastinal contours are normal. The hilar structures and pleural surfaces are unremarkable. There are no acute osseous abnormalities appreciated.

No acute cardiopulmonary process.

The lungs appear hyperexpanded. No focal consolidation, pleural effusion or pneumothorax identified. The size of the cardiac silhouette is within normal limits.

Hyperexpanded lungs. No radiographic evidence of acute cardiopulmonary disease.

Single portable view of the chest. The lungs are clear consolidation or large effusion. The trachea is mildly deviated to the left at the thoracic inlet raising possibility of underlying thyroid enlargement on the right. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities detected.

No acute cardiopulmonary process. Slight leftward deviation of the trachea at the thoracic inlet. Could repeat exam with PA and lateral technique to optimize positioning versus consider thyroid ultrasound.

There has been slight interval retraction of a right-sided chest tube which now projects over the mid right lung field. The inferior chest tube projects over the lower lung. Right-sided subcutaneous emphysema persists. Small right apical pneumothorax is unchanged. Large known upper lobe consolidation on the right appears similar to the prior exam with persistent mild right basilar atelectasis. Mild plate-like atelectasis is seen at the left lung base; otherwise, the left lung is clear. There is no interval change in the appearance of the cardiac silhouette. Small right-sided pleural effusion is persistent. The visualized osseous structures are unremarkable.

Unchanged small right apical pneumothorax with persistent right basilar atelectasis. Persistent small right pleural effusion.

An enteric tube is seen courseing below the diaphragm, terminating in the proximal stomach. There is prominence of the right hilum with suggestion of retraction seen. There is also opacity projecting over the right lung apex, as was also the case on the prior study. There appears to be volume loss in the right lung with elevation of the right hemidiaphragm as well. Areas of opacity in the right mid to lower lung appear somewhat increased and there is suggestion of right perihilar air bronchograms. There is slight blunting of the right costophrenic angle, which may be due to trace effusion or pleural thickening. The left lung is clear. No pneumothorax is seen. The cardiac silhouette is mildly enlarged.

Volume loss on the right hemithorax. Right pleural effusion. Increased opacities in the right mid to lower lung, with air bronchograms may be due infection and/or worsening of malignant disease.

Overall, two right-sided chest tubes are similar in position compared to the prior exam. Small right apical pneumothorax is unchanged. There has been slight interval improvement in the extent of the right subcutaneous emphysema. Large known upper lobe consolidation on the right appears similar to the prior exam with an interval increase in right lung base atelectasis. The left lung is clear aside from plate-like areas of atelectasis at the left lung base. There is no interval change in the appearance of the cardiac silhouette. There may be a small right-sided pleural effusion.

Unchanged small right apical pneumothorax with interval increase in right basilar atelectasis.

The cardiac, mediastinal and hilar contours appear stable. Patchy retrocardiac opacity appears streaky and probably due to atelectasis. Otherwise the lungs appear clear. There are no pleural effusions or pneumothorax.

Mild retrocardiac opacification, most commonly due to atelectasis also although not entirely specific.

NG tube tip is off the film, at least in the stomach. There is volume loss/ consolidation at both bases. Heart size is upper limits of normal.

The bilateral lower lobe volume loss/infiltrate

Single AP view of the chest. No prior. The lungs are clear of consolidation, vascular congestion or effusion. Cardiomediastinal silhouette is within normal limits. Osseous and soft tissue structures demonstrate no acute abnormality.

No acute cardiopulmonary process.

Portable chest radiograph demonstrates apparent widening of mediastinum this is due to patient rotation. Cardiomediastinal and hilar contours are unremarkable. Low lung volumes with vascular crowding. Lungs are clear. No pleural effusion or pneumothorax.

No acute intrathoracic process.

Heart is upper limits of normal in size and accompanied by mild pulmonary vascular congestion and small right pleural effusion. Bibasilar platelike atelectasis is slightly improved. There is no pneumothorax or focal consolidation. The cardiomediastinal silhouette is stable. The left-sided Bochdalek's hernia is unchanged. Impression on the right aspect of the trachea may be related to an enlarged thyroid gland.

No evidence of pneumonia.

A left chest wall port catheter tip terminates at the cavoatrial junction. The lungs are well expanded. There are worsening confluent basilar opacities, right greater than left with new patchy opacities in the right upper lobe. Diffuse ground glass and linear opacities have also progressed since the prior radiograph. Small bilateral pleural effusions are new. There is no pneumothorax. The cardiomediastinal silhouette is normal. The bones are intact.

Worsening multifocal opacities most confluent at the lung bases are concerning for worsening atypical infection and less likely asymetric pulmonary edema or hemorrhage.

Mild enlargement of the cardiac silhouette is present. The aortic knob is calcified. Mediastinal contours unremarkable. There is mild pulmonary edema along with small bilateral pleural effusions. Elevation the right hemidiaphragm is of unknown chronicity. Patchy opacities in lung bases may reflect areas of atelectasis. No pneumothorax is present. There are no acute osseous abnormalities demonstrated.

Mild pulmonary edema with small bilateral pleural effusions and bibasilar patchy opacities, likely atelectasis.

NG tube tip is seen in the stomach. A left-sided subclavian line ends in the mid SVC. A PICC is seen ending in the atriocaval junction. The lungs are otherwise clear of focal opacities. Heart size is normal. No obvious pleural effusions or pneumothoraces are seen. No pulmonary edema is present.

No acute cardiopulmonary process. Lines in position as above.

Lung volumes are low, accounting for bronchovascular crowding. There is no focal opacity concerning for pneumonia. Cardiomediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax.

Low lung volumes. No evidence of acute cardiopulmonary process.

There has been interval decrease in the size of the right pleural effusion status post drainage. There is a new small right apical pneumothorax. A nasogastric feeding tube courses below the hemidiaphragm, tip not visualized. Mild pulmonary edema is unchanged. Small left pleural effusion with associated left lower lobe atelectasis are unchanged. Surgical skin and metallic hardware in the cervical region are unchanged.

Status post drainage of right pleural effusion which is now small. New small right apical pneumothorax. Stable mild pulmonary edema, left lower lobe atelectasis and small left pleural effusion. with Dr.

The enteric tube courses below the hemidiaphragm, tip not visualized. Moderate right and small left pleural effusions are unchanged. Mild cardiomegaly despite the projection is unchanged. There is slightly increased pulmonary vascular congestion, and new obscuration of the left hemidiaphragm, which is most likely due to atelectasis. A tiny left apical pneumothorax shows no appreciable change. The patient has had previous cervical spine fusion.

New left lower lobe atelectasis. Slightly increased pulmonary vascular congestion. Stable tiny left apical pneumothorax.

The nasogastric tube enters the right main bronchus and extends well into the right bronchial tree. There is no pneumothorax. Mild pulmonary edema with moderate bilateral pleural effusions are unchanged. Moderate cardiomegaly despite the projection is also unchanged. Coarse vascular calcifications are incidentally noted. The patient has had prior cervical spine fusion.

Malpositioned NG tube enters the right main bronchus to terminate in the distal bronchial tree. Repositioning is advised. No other appreciable interval change.

Portable AP upright chest radiograph is obtained. The lungs appear clear bilaterally without focal consolidation, effusion, or pneumothorax. A left fifth rib fracture seen on CT is not evident on this chest radiograph. Cardiomediastinal silhouette appears normal.

No acute findings. Please refer to CT chest from outside hospital for further details.

The heart is normal in size. There is mild unfolding of the thoracic aorta. The mediastinal and hilar contours appear unchanged. The lungs appear clear. A nipple shadow is visualized on the left. A deformity of the left proximal humerus appears similar allowing for differences in technique. There is mild leftward convex curvature centered along the lower thoracic spine.

No evidence of acute disease.

Enteric tube tip in the mid stomach. Right Port-A-Cath tip near cavoatrial junction. Postoperative changes in the upper abdomen with drains, , IVC filter in place. Lungs are clear. Normal heart size, pulmonary vascularity. No effusion. No pneumothorax.

Postoperative changes. No acute cardiopulmonary changes.

The heart is again mildly enlarged but difficult to visualize on this film in its entirety. The aortic arch is again calcified. The lung volumes are low. Patchy perihilar opacification with indistinct pulmonary vascularity suggests mild vascular congestion or fluid overload. Otherwise, the examination is limited. It is difficult to exclude pleural effusions. There is no pneumothorax. Similar moderate relative elevation of the right hemidiaphragm is noted. Prominent lucency beneath the right hemidiaphragm appears very similar and is likely to reflect colonic interposition noting that the appearance is basically unchanged. There is a mildly prominent gas distended segment of bowel projecting over the right upper quadrant, potentially small bowel.

Findings suggesting mild vascular congestion. Similar elevation of the right hemidiaphragm with lucency compatible with colonic interposition, noting lack of change. However, clinical correlation is suggested. There is also mildly dilated segment of probable small bowel projecting over the right upper quadrant of the abdomen. Correlation with abdominal symptoms, if any, is recommended.

Persistent mild-to-moderate pulmonary vascular congestion; however, pulmonary edema is improved asymmetrically better on the right. Mediastinal silhouette remains stably at the upper limits of normal. Calcifications are noted at the aortic arch. Colonic interposition is again noted. Osseous structures remain normal.

Continued mild-to-moderate vascular congestion. However, pulmonary edema has improved asymmetrically better on the right.

Portable AP chest radiograph. Right basilar pleural pigtail is curled within the periphery of the right hemithorax with interval decrease in size of basal component of the loculated right pleural effusion. The more superior portion persists unchanged. Improved basilar aeration is noted. The left lung is clear. No pneumothorax is seen. Heart and mediastinal contours are unremarkable.

Status post placement of right basal pleural catheter located in the peripheral right hemithorax with decrease in the right basal component of the pleural effusion without pneumothorax.

An enteric tube side port projects over the mid stomach. No other significant changes are appreciated. Right upper lung and perihilar opacification is similar, probably a combination of known lung cancer with postobstructive pneumonia. Substantial emphysematous changes are stable bilaterally.

Unchanged appearance of right upper lobe opacities concerning for postobstructive pneumonia.

Similar to scout image from , there is large area of opacity in the right upper hemi thorax in right perihilar region concerning for postobstructive pneumonia secondary to known large juxta hilar mass. The left lung remains hyperinflated. No large pleural effusion is seen. There is no evidence of pneumothorax. The cardiac and mediastinal silhouettes are unremarkable.

Large area of right upper hemi thorax and right juxta hilar opacity, grossly similar in distribution as compared to the prior CT, although with possibly slightly more fluid in the right lung apex, overall worrisome for postobstructive pneumonia secondary to right juxta hilar mass. Reported right chest wall metastasis on prior CT better assessed on CT.

Cardiac, mediastinal and hilar contours are within normal limits. Lungs are clear. Pulmonary vasculature is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormality is visualized.

No acute cardiopulmonary abnormality.

AP upright portable chest radiograph is obtained. There is no evidence of free air below the right hemidiaphragm. The lungs appear clear bilaterally. Cardiomediastinal silhouette is normal. Bones appear intact.

No acute findings including no sign of pneumoperitoneum.

The AP view of the chest. The lungs are clear of confluent consolidation. Biapical scarring is again seen. Linear opacity at the left lung base most suggestive of atelectasis. Cardiomediastinal silhouette is within normal limits. Surgical clips seen in the left upper quadrant. There is no free intraperitoneal air. No acute osseous abnormality detected.

No acute cardiopulmonary process, no free intraperitoneal air.

The lungs are clear without focal infiltrate. There are minimal bilateral pleural effusions. The heart is upper limits normal in size. Aorta is mildly tortuous. There is apical pleural thickening.

No focal infiltrate.

Lung volumes are low on the right without convincing evidence of lobar atelectasis. There are multiple right-sided rib deformities consistent with old rib fractures. No pneumothorax. There is mild prominence of the bilateral hila and pulmonary vasculature consistent with a mild degree of congestive heart failure but no frank pulmonary edema. Mild cardiomegaly may be exaggerated by the projection. No consolidation or pleural effusion seen.

No frank pulmonary edema seen.

Left-sided Port-A-Cath terminates in the low SVC. New dense left lower lobe and lower under consolidation can be pneumonia and/or aspiration. There is likely adjacent pleural fluid. The right lung is clear. Heart size is normal. No pneumothorax.

New dense consolidation in the left lower lobe with associated moderate effusion can be pneumonia.

The lungs are clear with no focal opacities. There is some minimal bibasilar atelectasis. The cardiomediastinal silhouette and hilar contours are normal. The pleural surfaces are clear without effusion or pneumothorax. The left chest wall pacing device and pacer leads are unchanged in appearance.

No evidence of acute cardiopulmonary process.

There has been interval removal of the ET tube, Swan-Ganz catheter, chest tube, mediastinal drains, and NG tube. There is volume loss in both lower lungs. The heart is mildly enlarged. Sternal wires and mediastinal clips are again seen. There is minimal pulmonary vascular redistribution. There is no pneumothorax.

No pneumothorax post chest tube removal.

AP portable upright view of the chest. Overlying EKG leads are present somewhat limiting assessment. The heart appears top-normal in size. Interstitial opacities are noted bilaterally which could reflect chronic lung disease i. e. fibrosis and/or interstitial pulmonary edema. Please correlate clinically. No large effusion or pneumothorax. No focal opacity concerning for pneumonia. Bony structures are intact

Interstitial opacities noted bilaterally which could reflect chronic lung disease and/or pulmonary interstitial edema. Please correlate clinically.

Dual lead left-sided pacer device is stable in position. The cardiac and mediastinal silhouettes are stable. No focal consolidation is seen. There is no pleural effusion or pneumothorax. No pulmonary edema is seen.

Stable position of the left ICD. No pulmonary edema.

Right chest wall port is seen with catheter tip at the RA SVC junction. There is a moderate right-sided pneumothorax which is new from prior. There is no definite signs of tension. Linear opacity at the left lung base is likely atelectasis. The lungs are otherwise clear. The cardiomediastinal silhouette is within normal limits. No acute osseous abnormalities identified. Subcutaneous gas projects over the right axilla.

New moderate right sided pneumothorax.

Heart size in cardia mediastinal silhouettes are unchanged. Lungs are fully expanded and clear without focal consolidation. No pleural effusions or pneumothorax.

Interval removal of pericardial drain, otherwise no significant changes. If concerned about pericardial effusion, echocardiogram is recommended.

m. and allowing for technical differences, no definite change is identified. Again seen is patchy opacity in the right infrahilar region and at the left base (previous chest x-ray suggested in the left lower lobe). Cardiomediastinal silhouette is unchanged. There is upper zone redistribution, without overt CHF. No new focal opacity is detected. No pneumothorax is identified. Densities in the upper abdomen likely relate to prior embolization.

Allowing for technical differences, doubt significant interval change compared with earlier the same day. Again noted (but better seen on the most recent prior study), are non-specific patchy opacities in the right middle and left lower lobes. Chest CT is recommended for further assessment of these opacities and for evaluation of the apparent interval increase in the size of the mediastinum compared with .

ETT in standard position. Enteric feeding tube traverses the midline and ends in the left upper quadrant, unchanged. Atelectasis of the left lung base is mild. Otherwise, the lungs are clear. No focal consolidation, pleural effusion, pulmonary edema, or pneumothorax. The heart is normal in size. The mediastinum is not widened. The hila are unremarkable.

ETT in standard position.

There are relatively low lung volumes. Large opacity projecting over the left mid to lower lung fields with subtle air bronchograms seen is worrisome for pneumonia. No definite pleural effusion is seen, although small left pleural effusion is difficult to exclude. The right lung is clear. There is no pneumothorax. The cardiac and mediastinal silhouettes are unremarkable.

Large left lower lobe consolidation worrisome for pneumonia.

Lung volumes are low. Heart size is normal. Mediastinal contours are unremarkable, though the superior mediastinum is not well assessed as the patient's chin obscures this region. Tracheostomy tube is in unchanged position. Hilar contours are normal. There is no pulmonary edema. Minimal blunting of the left costophrenic angle may suggest a small pleural effusion. Retrocardiac patchy opacity and minimal right basilar opacity likely reflect atelectasis. No pneumothorax is identified but the apices are not well assessed due to the patient's chin and soft tissues of the neck obscuring these regions. There is no acute osseous abnormality.

Limited assessment. Bibasilar patchy opacities likely reflect atelectasis in the setting of low lung volumes, but infection or aspiration cannot be excluded completely.

There is a small right-sided pneumothorax with a chest tube traversing medially and terminating along the right mediastinal border. The heart size is mildly enlarged. There is mild pulmonary vascular congestion. Note is made of subcutaneous emphysema along the right lateral chest wall. Increased opacities at the mid right lung, is likely secondary to aspiration. No acute fracture is identified. The left lung aside from mild pulmonary vascular congestion is otherwise clear. There is no large pleural effusion.

Chest tube in appropriate position with small right-sided pneumothorax. Increased opacities at the mid right lung is likely secondary to aspiration. Continued close interval follow up is recommended.

Orogastric tube tip courses below the diaphragm, off the inferior borders of the film. The heart size is normal. The mediastinal and hilar contours are unremarkable. The lungs are clear and the pulmonary vascularity is normal. No pleural effusion or pneumothorax is present. No acute osseous abnormality seen.

Endotracheal tube and orogastric tube in standard positions. No acute cardiopulmonary abnormality.

Portable frontal upright radiograph of the chest. Lower lung volumes are noted. Mild enlargement of the cardiac silhouette is again noted, perhaps slightly smaller than on prior study. No focal consolidation, pleural effusion or pneumothorax is present. Vascularity is within normal limits.

No evidence of pneumonia.

AP portable upright view of the chest. Patient is slightly leftward rotated. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air is seen below the right hemidiaphragm.

No acute intrathoracic process. No signs of pneumoperitoneum.

Allowing for technical differences, the parenchymal findings are similar, possibly slightly worse. No effusions are identified. ET tube and NG tube are similar. The cardiomediastinal silhouette is probably unchanged.

Radiopaque portion of aortic balloon pump now lies slightly higher. Clinical correlation regarding retraction is requested. Diffuse alveolar opacities, with relative sparing of lung bases, are similar, possibly slightly worse.

Compared to the prior film, the tip of the aortic balloon pump appears to lie higher. Though the aortic knob is not well delineated, it appears to lie at the top of the expected location of the aortic knob. NG tube, beneath the diaphragm, with tip overlying fundus. Catheter from an inferior approach, question Swan-Ganz catheter, with tip overlying the region of the main pulmonary artery. Compared to the prior study, there may have been slight leftward shift of the mediastinum. Again seen are diffuse patchy opacities throughout both lungs, most pronounced in the upper zones, with relative sparing of the lower zones. Density of the left upper zone is more confluent than on the prior study. There are not fully characterized, but could represent an atypical distribution of CHF with pulmonary edema or other alveolar infiltrates.

Positioning of aortic balloon pump is thought to be high- see comments above. Possible slight interval leftward shift of the mediastinum, suggesting the presence of some volume loss on the left. Dense, somewhat patchy, bilateral alveolar infiltrates, with upper zone predominance. This is not fully characterized. In the appropriate clinical setting, this could represent atypical distribution of pulmonary edema, ARDS, or other causes of alveolar infiltrates. Possibility of a component pleural fluid or apical capping cannot be excluded. If clinically indicated, chest CT may help for more complete characterization.

Slightly rotated positioning. An NG tube an NG type tube is present, tip overlying the gastric fundus, beneath the diaphragm. An IABP is present, extending from an inferior approach. The aortic knob itself is not well-defined, but the radiopaque tip probably lies at or immediately below the lower edge of the aortic knob. There are dense, confluent opacities in both upper zones, extending into the mid/ lower zones, but with sparing of both lung bases. The degree of confluence is greater on the left. No effusion is identified. Cardiomediastinal silhouette is at the upper limits of normal, but not frankly enlarged. No pneumothorax is detected.

ET and NG tubes, as described. IABP radiopaque tip probably lies at or immediately below the inferior edge of the aortic knob. Dense left-greater-than-right opacities, with upper lobe predominance and sparing of the bases. While this could represent an atypical distribution of CHF, including changes associated with valve dysfunction, in the appropriate clinical setting, the upper lobe predominance would also raise the question of infectious or inflammatory etiologies.

AP single view of the chest has been obtained with patient in sitting semi-upright position. Comparison is made with the next preceding similar study obtained four hours earlier during the same day. Again identified is status post right upper lobectomy with moderately elevated right-sided diaphragm and local chest wall emphysema in the right shoulder area. No pneumothorax has developed since the preceding study, and no new infiltrates are seen.

Stable chest findings as seen on portable followup examination, status post right upper lobectomy.

Single AP upright portable view of the chest was obtained. Lungs are clear without focal consolidation. No pleural effusion or pneumothorax is seen. Cardiac and mediastinal silhouettes are stable and unremarkable with calcifications at the aortic knob. No evidence of free air is seen beneath the diaphragms. The right paratracheal opacity is stable since the prior study.

No acute cardiopulmonary process. No evidence of free air beneath the diaphragms.

Patient is status post coronary artery bypass graft surgery. The cardiac, mediastinal and hilar contours appear unchanged including moderate cardiomegaly. What is new is bilateral opacification of each lung base, which is especially confluent in the retrocardiac region on the left. Particularly on the right, small coinciding pleural effusion is suspected. Indistinct pulmonary vasculature appears mildly distended suggesting coinciding vascular congestion.

Substantial opacities at both lung bases, raising concern for pneumonia. Findings also suggest mild coinciding vascular congestion and possibly small pleural effusions.

AP portable supine view of the chest. Underlying trauma board is in place. Lungs appear clear. No supine evidence of effusion or pneumothorax. The cardiomediastinal silhouette appears grossly within normal limits. No acute bony injury.

Limited, negative.

The heart size is normal. The mediastinal and hilar contours are unchanged. The pulmonary vasculature is not engorged. Persistent crescentic focal opacity is noted within the left lower lobe, which could reflect an area of infection or atelectasis. Minimal streaky opacities elsewhere in both lung bases are compatible with areas of atelectasis. No pleural effusion or pneumothorax is seen. Mild paraseptal emphysematous changes are noted in the lung apices. There are no acute osseous abnormalities.

Persistent crescentic area of opacification within the left lower lobe which may reflect an area of infection or atelectasis.

Since the prior CXR, there has been interval placement of an enteric tube that terminates in the stomach, but the sidehole is at the GE junction. The right sided PICC line has been advanced and now terminates in the mid right atrium. There has been interval worsening of the right layering pleural effusion and adjacent atelectasis. No left pleural effusion. No pneumothorax. Heart size is top normal. Mediastinum appears widened, likely due to patient rotation. Cervical fusion device is unchanged in location.

Interval advancement of the right PICC line, which now terminates in the right atrium. Worsening layering right effusion. by Dr.

There has been interval increase in the right pleural effusion is layering posteriorly. There content there continues to be dense retrocardiac opacification that has increased in the interval. There is probably a small left effusion as well. NG tube tip is off the film, at least in the stomach. Right-sided PICC line tip is at the cavoatrial junction

Worsened fluid status.