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mimic_chest_xray_v_1_train

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

Right chest tube is in place. Bilateral pleural effusions are large, unchanged. Vascular congestion is present. No pneumothorax is present.

chest x-ray; 'Edema'

Portable AP upright chest radiograph was obtained. Lungs are somewhat low in volume with resultant bronchovascular crowding. Within this limitation, there may be mild pulmonary edema. Cardiac size remains stably enlarged. No pneumothorax or pleural effusion is identified.

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

Compared to chest radiographs ___. Left lower lobe atelectasis is still severe, small left pleural effusion is smaller. Previous mild pulmonary edema and mediastinal venous engorgement have improved. No pneumothorax. Midline and left pleural drains in place. ET tube in standard placement. Nasogastric drainage tube passes into the stomach and out of view. Swan-Ganz catheter ends in the right pulmonary artery.

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

Moderate pulmonary edema is improved with unchanged linear left basal atelectasis and more dense left basal consolidation. Cardiac silhouette is unchanged. No pneumothorax is seen. Moderate gastric distension is noted.

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

New endotracheal tube in standard placement. Nasogastric tube ends in the region of the pylorus. Severe bibasilar atelectasis has not improved, but previous mild pulmonary edema has cleared. Small left pleural effusion stable. No definite pneumothorax. Heart size normal, exaggerated by low lung volumes.

chest x-ray; 'Cardiomegaly'

In comparison with study of ___, there are lower lung volumes, which may account for the increased prominence of the transverse diameter of the heart. Mild elevation of pulmonary venous pressure is seen. The tip of the IABP lies between the left mainstem bronchus and transverse arch of the aorta.

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

In comparison with the study of ___, the tip of the left IJ catheter remains in the right atrium. Nasogastric tube extends well into the stomach and the endotracheal tube has been removed. There is again some elevation of the right hemidiaphragmatic contour with mild atelectatic changes at the base. No evidence of vascular congestion.

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

There has been interval repair of the left-sided diaphragmatic rupture. There has been interval re-expansion of the left lung. The left lung is clear. There has appears to be interval increase in opacification of the right lung, likely secondary to pulmonary edema and pulmonary vascular congestion. There is no pneumothorax. There are no definite pleural effusions. Heart size is normal. ET tube terminates 2.7 cm above the carina. The bilateral chest tubes are in place. There seems to be an NG tube coiled in the upper esophagus. There are opacifications in the left subdiaphragmatic area, likely secondary to drains, however a foreign body cannot be ruled out.

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

As compared to the previous radiograph, no relevant change is seen. The pre-existing lung parenchymal opacities are constant in extent and severity. There are no new opacities. The position of the left central venous access line as well as of the sternal wires is constant. Unchanged size of the cardiac silhouette.

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

Again seen is widespread lucency throughout the upper zones, denoting COPD. No pneumothorax is detected. A subtle right lower lobe lung mass measuring up to 6.5 cm is again seen, unchanged in configuration. Mild pulmonary edema has improved since ___. There is no large effusion. The hilar and mediastinal contours remain stable.

chest x-ray; 'Cardiomegaly'

In comparison with the earlier study of this date, following the bronchial brushing procedure there is no evidence of pneumothorax. Little overall change in the appearance of the heart and lungs from the study of ___.

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

In comparison with the study of ___, there has been placement of a right IJ catheter that extends to the mid portion of the SVC. Other monitoring and support devices are essentially unchanged. Retrocardiac opacification is again consistent with volume loss in the left lower lobe. Mild atelectatic changes are seen at the right base. There is some indistinctness of pulmonary vessels, suggesting some elevation of pulmonary venous pressure.

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

There is no evident pneumothorax. Small left pleural effusion has increased. Cardiomediastinal contours are unchanged. Patient has known right pleural thickening and right pleural effusion better seen in prior CT from ___

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

Support and monitoring devices are in standard position. Interval slight increase in cardiac silhouette accompanied by widening of mediastinal vascular pedicle and azygos vein as well as development of mild pulmonary vascular congestion. Lower lung predominant airspace opacities have slightly worsened.

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

There has been markedly improved aeration of the left lung, large areas of opacity still remaining in the left upper lobe. Mediastinal structures are now midline. Right lower lobe atelectasis is increased. Right IJ catheter tip is in the cavoatrial junction. Cardiac size cannot be evaluated. Left pigtail catheter remains in place.

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

In comparison with the earlier study of this date, the right chest tube is been removed and there is little change in the degree of apical pneumothorax. Left pleural drain is again seen and the tiny apical pneumothorax is stable on this side. Otherwise, little change in the appearance of the heart and lungs.

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

As before, tip of right IJ central line lies at SVC/RA junction. The cardiomediastinal silhouette is unchanged, allowing for differences in positioning. Minimal upper zone redistribution, without overt CHF. Patchy opacity in the retrocardiac region is improved compared with ___ not clearly changed from ___. Minimal atelectasis at the right lung base is slightly improved. As before, there is interruption of the right fifth rib posteriorly, which appears old and mild undulation of the lower right chest rib.

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

In comparison with the study of ___, the endotracheal and nasogastric tubes have been removed. Following chest tube removal, there is no evidence of pneumothorax. Continued low lung volumes. The left hemidiaphragm is not sharply seen, suggesting small pleural effusion and some volume loss in the left lower lobe.

chest x-ray;

The endotracheal tube terminates 5 cm from the carina. The degree of vascular congestion has increased, with possible small bilateral pleural effusions. Atelectasis of the left lower lobe is unchanged. No focal consolidation concerning for pneumonia. A hiatal hernia is unchanged, and an NG tube follows the hernial contour below the diaphragm.

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

Comparison to ___. Moderate cardiomegaly persists. Unchanged monitoring and support devices. No overt pulmonary edema, but signs of mild fluid overload are present. The presence of a minimal right pleural effusion cannot be excluded. Unchanged left retrocardiac atelectasis.

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

AP chest compared to ___: Right lung base is persistently elevated, probably due to subdiaphragmatic displacements. Result is persistent right lower lobe atelectasis, where it would be difficult to pick up an early pneumonia, and probably a small right pleural effusion. The upper lungs are clear. Moderate enlargement of the cardiac silhouette is stable and there is no left pleural effusion. A dialysis ends in the right atrium.

chest x-ray; 'Edema'

An endotracheal tube is present, nominal in position. A right subclavian PICC line tip overlies the distal SVC. There is diffuse vascular plethora and vascular blurring, consistent with CHF new compared with ___. There is obscuration of both diaphragms and the possibility of pleural fluid and/or basilar collapse and/or consolidation cannot be excluded on this view.

chest x-ray; 'Enlarged Cardiomediastinum'

The heart is moderately enlarged. There is a convex contour to the right upper mediastinum that is most often due to tortuosity of the great vessels, although not entirely specific. Mild diffuse interstitial abnormality including prominence of upper zone pulmonary vascularity, which also appears indistinct, suggests mild pulmonary vascular congestion. Patchy and medial left lower lung opacities suggest minor atelectasis. Surgical clips project along the left axilla. Moderate degenerative changes involve the right glenohumeral joint, which shows moderately large osteophytes.

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

The nasogastric tube has its tip overlying the upper mid chest at the level of the carina. Removal and repositioning is advised at this time. A wet reading was provided to ___ by Dr. ___ by phone on ___ at 9:12 p.m. Right subclavian central line has its tip in the mid to distal SVC. Heart remains enlarged status post median sternotomy. Overall mediastinal contours are stable. There continue to be patchy opacities in both lungs with associated layering effusions. These findings most likely reflect a combination of pulmonary edema as well as compressive atelectasis, although pneumonia cannot be entirely excluded. No pneumothorax.

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

Cardiomediastinal silhouette is within normal limits. There are low lung volumes. There are diffuse airspace opacities bilaterally. This may represent aspiration, pulmonary edema, or infectious etiology. Follow up to resolution is recommended. There are no pneumothoraces.

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

As compared to the previous radiograph, there is no relevant change. Bilateral pleural effusions, left more than right with areas of atelectasis and unchanged evidence of mild-to-moderate fluid overload. The monitoring and support devices are constant. Constant size of the cardiac silhouette.

chest x-ray;

Single frontal view of the chest was obtained. The lungs are hyperinflated with flattening of the diaphragms, suggesting chronic obstructive pulmonary disease. There is linear right basilar atelectasis/scarring. Relative lucency of the upper lungs also suggests presence of pulmonary emphysema. Skinfold is noted overlying the left upper hemithorax. No pneumothorax is seen. There is no pleural effusion. The aorta is calcified and tortuous. The cardiac silhouette is not enlarged. There is no pulmonary edema.

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

The heterogeneous, perihilar abnormality that developed in both lungs between ___ and ___ and worsened subsequently, has improved over the past 24 hours. The distribution suggests atypical pneumonia rather than edema, but edema is not excluded. Heart is normal size, though increased slightly compared to ___. Pleural effusions are small if any. No pneumothorax.

chest x-ray; 'Atelectasis'

No previous images. The heart is normal size and there is no vascular congestion, pleural effusion, or acute focal pneumonia. Streaks of atelectasis are seen at both bases.

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

In comparison with the study of ___, the monitoring and support devices are essentially unchanged. Bilateral basilar opacifications are consistent with layering effusions and underlying compressive atelectasis. Some indistinctness of pulmonary vessels suggests elevated pulmonary venous pressure.

chest x-ray; 'No Finding'

In comparison with the earlier study of this date, a left IJ hemodialysis catheter is unchanged. . No evidence of pneumothorax. Diffuse bilateral pulmonary opacifications Are again visualized and appear similar compared to the study from the prior day.

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

In comparison to ___ chest radiograph, a moderate sized left pneumothorax has developed with apical lateral and basilar components. Additionally, increased opacity has developed in the left mid lung region at a site of recent biopsy procedure potentially representing post procedural hemorrhage.

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

Portable semi-upright radiograph of the chest demonstrates low lung volumes with resultant bronchovascular crowding. Again seen is moderate postoperative atelectasis in the retrocardiac region, which is unchanged, as well as a persistent small left-sided pleural effusion. The cardiomediastinal and hilar contours are unchanged. There is no pneumothorax.

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

Dobhoff feeding tube passes to the distal stomach. The portion of the tube the neck, in in the upper esophagus and hypopharynx, is not imaged on the chest radiograph. Right PIC line ends in the low SVC. Lungs clear. Heart size normal. No pleural abnormality.

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

In comparison with the study of ___, allowing for some differences in position, there is probably little change. Enlargement of the cardiac silhouette persists. Mild fullness of pulmonary vessels is consistent with elevated pulmonary venous pressure. Opacification at the left base suggests atelectasis and effusion. In the appropriate clinical setting, superimposed pneumonia would have to be considered. Endotracheal tube and nasogastric tube remain in place.

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

A portable frontal chest radiograph demonstrates a left chest tube. There is no pneumothorax. Volume loss of the left lower lung with elevation of the left hemidiaphragm is consistent with lobectomy. The cardiomediastinal silhouette is normal, without atelectasis at the left base. There is no focal consolidation, pleural effusion, or pneumothorax.

chest x-ray; 'Cardiomegaly'

In comparison with the study of ___, there is little change in the appearance of the heart and lungs. Specifically, no evidence of interval aspiration or pneumonia.

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

There remains a large mass within the left upper lobe concerning for malignancy as seen on the prior chest CT. Cardiac silhouette is within normal limits. There is some mild elevation of the right hemidiaphragm. No pneumothoraces are seen. Atelectasis at the lung bases are present, right side worse than left. No pleural effusions are seen.

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

In comparison with the earlier study of this date, there has been placement of an endotracheal tube with its tip approximately 3 cm above the carina. The patient has taken a better inspiration and there is no evidence of acute cardiopulmonary disease.

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

AP single view of the chest has been obtained with patient in semi-upright position. Comparison is made with the next preceding similar study of ___. The left-sided PICC line has been pulled back by a few centimeters and is now seen to terminate just below the level of the carina. This implies a pull-back by approximately 5 cm. The present termination point corresponds to the mid portion of the SVC and excludes the possibility of mechanical contact with cardiac structures. No other new cardiopulmonary vascular abnormalities are identified.