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mimic_chest_xray_v_1

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chest x-ray; 'Atelectasis'

Low lung volumes are present, which accentuates the size of the cardiac silhouette which is at least moderately enlarged. Aortic arch calcifications are present. Mild widening of the superior mediastinum is presumably due to low lung volumes. There is crowding of the bronchovascular structures without overt pulmonary edema demonstrated. Bibasilar airspace opacities likely reflect atelectasis. No large pleural effusion or pneumothorax is seen. There are no acute osseous abnormalities.

chest x-ray; 'Fracture'

In comparison with the study of ___, there is no change in the appearance of the indwelling port, the tip of which is in the mid to lower portion of the SVC. No pneumonia, vascular congestion, or pleural effusion. Again there is evidence of previous healed rib fracture

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

The endotracheal tube ends at the level of the clavicles. An NG tube terminates in the stomach. A right PICC line is unchanged in position, ending in the mid SVC. Moderate right has slightly increased, but the small left layering pleural effusion is unchanged. There is no pneumothorax. Heart size appears slightly larger, which may be due to a combination of poor inspiration and pleural fluid.

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

As compared to the previous radiograph, the Swan-Ganz catheter has been slightly pulled back. The tip now projects over the outflow tract of the pulmonary trunk. No evidence of complications. Unchanged moderate cardiomegaly. No pneumothorax or pleural effusions.

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

In comparison with the outside study of ___, there is now an endotracheal tube in place with its tip approximately 4.3 cm above the carina. Nasogastric tube extends well into the stomach. Single lead pacer device extends to the right ventricle. There is enlargement of the cardiac silhouette with pulmonary vascular congestion. In the appropriate clinical setting, the possibility of superimposed aspiration would have to be considered, especially in the left upper and left lower lung zones.

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

Comparison is made with prior study, ___. Diffuse bilateral lung opacities, larger on the left side, are unchanged, consistent with patient's clinical diagnosis of ARDS. Cardiomediastinal contours are stable. ET tube is in standard position. Right central catheter tip is in the mid SVC. NG tube tip is in the stomach.

chest x-ray; 'Cardiomegaly'; 'Consolidation'

1. Interval appearance of bibasilar airspace consolidations, right greater than left which are concerning for pneumonia or aspiration. No evidence of pulmonary edema. No pneumothorax. The heart is upper limits of normal in size given portable technique. Mediastinal contours are within normal limits. No acute bony abnormality.

chest x-ray; 'No Finding'

Semi-upright portable chest radiograph demonstrates no focal consolidation, effusion, or pneumothorax. Cardiomediastinal silhouette is normal. Bony structures are intact.

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

Interval increase in size of cardiac silhouette accompanied by widening of vascular pedicle in keeping with increased volume status of the patient. New pulmonary vascular congestion is accompanied by minimal asymmetrical left perihilar edema. Marked elevation of right hemidiaphragm is unchanged.

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

There has been interval removal of a Swan-Ganz catheter and endotracheal tube. RIJ venous catheters ends in the upper and mid SVC. A mediastinal drain is in place. Right basilar chest tube is unchanged in position. There is no definite pneumothorax. Cardiomediastinal silhouette grossly unchanged. There is no pleural effusion. There is mild vascular congestion, lungs are otherwise clear.

chest x-ray; 'No Finding'

The heart size is top normal. Mediastinal silhouettes are normal. Lungs are clear without focal consolidation, pleural effusion, or pneumothorax. Incidental note of a presumed spinal stimulator lead in the midline.

chest x-ray; 'Edema'; 'Enlarged Cardiomediastinum'

Single AP supine portable view of the chest was obtained. Endotracheal tube terminates approximately 2.4 cm above the level of the carina. Enteric tube is seen coursing below the level of the diaphragm, coiled in what is likely the stomach. There is a left-sided internal jugular central venous catheter which terminates in the low SVC. There are relatively low lung volumes. Prominence of the hila is likely related to pulmonary edema. Patchy left basilar opacity could relate to pulmonary edema, although underlying aspiration is not excluded. No large pleural effusion or evidence of pneumothorax is seen. The cardiac silhouette is likely accentuated by AP, supine technique, but may be mildly enlarged. Also, there is mild prominence of the superior mediastinum which is also most likely accentuated by supine position and AP technique. If there is clinical concern for acute mediastinal injury, chest CTA is more sensitive.

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

In comparison with the study of ___, there is continued enlargement of the cardiac silhouette with pulmonary edema and bilateral pleural effusions with compressive atelectasis at the bases. Pacemaker device remains in place. Opacification over the lower portion of the glenohumeral joint on the right is again seen. When the condition of the patient improves, views of the right shoulder would be helpful.

chest x-ray; 'No Finding'

Minimal left base atelectasis seen. There is no focal consolidation. No pleural effusion or pneumothorax is seen. The cardiac silhouette is likely exaggerated by supine position and AP technique ; given this, is likely normal in size. . Mediastinal contours are grossly unremarkable. There is no pulmonary edema.

chest x-ray; 'Atelectasis'

As compared to ___, left bronchial stent appears to have migrated inferiorly. No pneumothorax. Low lung volumes and portable x-ray can cause crowding of the bronchovascular markings versus mild pulmonary vascular congestion. Increasing subsegmental atelectasis in the lingula and lower lobes bilaterally.

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

Lung volumes are low. Left-sided chest tube is noted with tip projecting over the left upper lung field. Small amount of subcutaneous emphysema is demonstrated within the left lateral chest wall. No pneumothorax is clearly visible on this exam. Heart size is accentuated due to low lung volumes, but likely mildly enlarged. The mediastinal and hilar contours are unremarkable. Crowding of the bronchovascular structures is noted. Small left pleural effusion is demonstrated. Bibasilar airspace opacities, more pronounced in the retrocardiac region, may reflect atelectasis though infection is not excluded. There are no acute osseous abnormalities detected.

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

Endotracheal tube tip is 5.3 cm above the carina and is appropriately positioned. Lower lung opacity has worsened over last 24 hours and in addition a small left pleural effusion is new. Apart from minimal right basal atelectasis the right lung is clear. Mildly enlarged heart size is stable. Mediastinal and hilar contours are unremarkable.

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

There is new bilateral lower lobe infiltrates, markedly increased compared to the prior study. There is mild pulmonary vascular redistribution. There is retrocardiac opacity with obscuration of the left hemidiaphragm. The heart is mildly enlarged. This most likely represents an infectious infiltrate, but CHF cannot be excluded.

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

Endotracheal tube is seen with tip approximately 3 cm from the carina. Enteric tube seen within the gastric body, side-port past the GE junction. Filter projects over the IVC. Bilateral parenchymal opacities are seen as on prior. Cardiac silhouette is enlarged. No acute osseous abnormalities identified.

chest x-ray; 'Lung Opacity'

AP portable view of the chest. A left-sided PICC ends in the distal SVC. Heart size is at least top normal. The mediastinal contours are unchanged. There is increase in pulmonary vascular congestion. There are bibasilar opacities, left greater than right, that may represent pneumonia or atelectasis. No pneumothorax. Probable small left pleural effusion.

chest x-ray; 'Atelectasis'

The heart size is mildly enlarged. There is cephalization of pulmonary vascular markings and vascular indistinctness compatible with mild pulmonary vascular congestion. Atherosclerotic calcifications are noted at the aortic knob. Streaky opacities in the lung bases likely reflect atelectasis. No pleural effusion or pneumothorax is seen, and no focal consolidation is present. There is mild prominence of the hila bilaterally.

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

Portable AP radiograph of the chest was reviewed in comparison to ___ obtained at 3:44 p.m. The ET tube tip is 6 cm above the carina. The NG tube tip is in the stomach. Heart size and mediastinum are unchanged in appearance including bilateral enlargement of the hila. Left lower lobe consolidation in the retrocardiac area is consistent with area of atelectasis versus pneumonia, again unchanged in appearance. There is interval decrease in right pleural effusion as compared to studies going back to ___.

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

The Dobbhoff tube courses below the diaphragm with the tip in the stomach. The left pleural effusion has increased in size since the prior exam with stable associated atelectasis. The right basilar atelectasis has resolved. There is no pulmonary edema or pneumothorax. The cardiomediastinal silhouette is normal.

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

AP chest compared to ___: Severe cardiomegaly, and pulmonary vascular engorgement have progressed, but there is no pulmonary edema nor appreciable pleural effusion. Transvenous right atrial and right ventricular pacer leads follow their expected courses.

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

A single portable semi-erect chest radiograph was obtained. Small left and moderate layering right pleural effusions have increased in size since the preceding day's exam. The right middle lobe pnemonia seen on recent CT is not clearly differentiated, but the right heart border is obscured. Left basilar atelectasis is stable. No new focal consolidation or pneumothorax is present. Hila remain indistinct. A left-sided PICC line tip remains in the upper SVC.

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

Low lung volumes, resulting in bronchovascular crowding. Small bilateral pleural effusions with adjacent atelectasis. Right internal jugular central venous line ends at the mid SVC.

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

Right lower lobe collapse and small right pleural effusion unchanged. Lungs otherwise grossly clear. Heart size normal. No pneumothorax.

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

Following insertion of a right basal pigtail pleural drainage catheter, right pleural effusion has almost entirely resolved, but there is a moderate right pneumothorax, in the right lower hemithorax suggesting pleural adhesions superiorly. Poor inflation of the right lung base is due to localized visceral pleural thickening and/or adhesive atelectasis. Moderate to severe enlargement of the cardiac silhouette is stable. Mild interstitial edema is probably present, as well as a very small left pleural effusion. The upper esophagus is distended with air, not necessarily pathologic. Left subclavian pacer lead tip projects over the cardiac apex, presumably running along the floor of the right ventricle. No left pneumothorax.

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

Since a recent radiograph of 1 day earlier, endotracheal tube has apparently been advanced, with tip now terminating approximately 1.5 cm above the carina. This could be withdrawn a few cm for standard positioning. Exam is otherwise remarkable for decrease in extent of widespread bilateral alveolar opacities.

chest x-ray; 'Fracture'

Comparison to ___. Moderate hiatal hernia. No chest wall abnormalities. No rib fractures. No pleural effusions. No pneumothorax, no pulmonary edema or pneumonia. Normal size of the heart.

chest x-ray; 'Atelectasis'; 'Lung Opacity'; 'Pleural Other'; 'Pneumothorax'

Left lateral chest wall subcutaneous emphysema again noted. The previously reported small left apical pneumothorax is not definitively seen on this examination. Patchy bibasilar opacities, left greater than right, which likely reflect atelectasis, although superimposed pneumonia cannot be excluded. There continues to be left lateral pleural thickening which could reflect a component of loculated fluid. No evidence of pulmonary edema. Overall cardiac and mediastinal contours are likely unchanged but somewhat difficult to assess due to the opacification at the left base.

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

Nasogastric tube is seen coursing below the diaphragm with the tip not identified. The aortic contour appears somewhat prominent but unchanged since ___ at 15:18 and therefore is likely positional. Heart remains mildly enlarged. No focal airspace consolidation is seen to suggest pneumonia. No pulmonary edema. Blunting of the left costophrenic angle may reflect scarring or a small effusion. No pneumothorax.

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

In comparison with study of ___, there is again complete opacification of the left hemithorax with shift to the ipsilateral side, consistent with lung collapse. This most likely is related to mucus plugging. The right lung is essentially clear except for a small residual effusion with atelectatic changes at the bases.

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

Tracheostomy tube remains in standard position. Mild cardiomegaly is accompanied by pulmonary vascular congestion and mild edema. Left retrocardiac opacity has slightly improved, but nonspecific opacities in the right mid and lower lung have worsened, and are accompanied by persistent moderate right pleural effusion. Small left pleural effusion is unchanged.

chest x-ray; 'Lung Opacity'

Portable semi-upright radiograph of the chest demonstrates increased opacification of the bilateral bases, which may represent atelectasis, aspiration, or pneumonia in the appropriate clinical setting. Heart and mediastinal contours are unremarkable. The patient is status post tracheostomy, which ends 4.5 cm from the carina.

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

Low lung volumes with persistent prominence of interstitial markings likely interstitial edema. No pleural effusions. Severe cardiomegaly is unchanged. Diffuse demineralization noted. EKG leads overlie the chest wall.

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

In comparison with the study of ___, the monitoring and support devices remain in place. The patient has taken a better inspiration, which may account for the improved appearance of the pulmonary vasculature. Bibasilar opacifications are consistent with atelectasis and possible small effusions.

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

Right PICC has been replaced or repositioned, now terminating in the lower superior vena cava. Otherwise, no relevant short interval change since the recent study.

chest x-ray; 'Fracture'

AP chest compared to ___: Previous pulmonary and mediastinal vascular engorgement have resolved. Heart size top normal. Lungs clear. No pneumothorax. Multiple healed rib fractures on the right, left upper posterior rib fractures are new and not appreciably changed. No pneumothorax or pleural effusion.

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

Lung volumes continue to be low with no focal consolidation. Moderate cardiomegaly persists with unchanged pulmonary edema and small bilateral effusions. The ET tube is in appropriate position, and the gastric tube and left subclavian chest radiograph. Right IJ central venous line ends at the lower SVC, and the previous left IJ central venous line has been removed.

chest x-ray; 'Edema'

An NG tube remains in unchanged position overlying the proximal jejunum. The left PICC line has been removed. There has been interval improvement in mild pulmonary vascular congestion. Bibasilar atelectasis is unchanged. No focal consolidation or pneumothorax is present. The cardiomediastinal silhouette is unchanged.

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

No relevant change as compared to the previous image. The patient is intubated. The tip of the endotracheal tube projects approximately 4.5 cm above the carinal. The nasogastric tube is in situ and is, in unchanged manner, slightly coiled in the stomach. The tip of the tube is not included on the image. Right internal jugular venous introduction sheet. Normal lung volumes. No pulmonary edema. Retrocardiac and right basilar atelectasis. Borderline size of the cardiac silhouette. No pneumothorax.

chest x-ray; 'No Finding'

Cardiac size is normal. Moderate hiatal hernia is again noted. The lungs are hyperinflated. Patient has known emphysema. Small lung nodules, and lingular atelectasis are better seen in prior CT. There is no pneumothorax or pleural effusion.

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

Cardiac size is top-normal. Lines and tubes are in standard position. Extensive bilateral opacities larger in the lower lobes have mildly increased. There is no pneumothorax or pleural effusion

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

Compared to chest radiographs ___, most recently 21:27. ET tube in standard placement. New esophageal feeding tube, with the wire stylet in place, ends close to the pylorus. Transvenous right ventricular pacer lead continuous from the left pectoral generator to the right ventricular apex. No pneumothorax mediastinal widening or appreciable pleural effusion. Bibasilar atelectasis is mild.

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

Substantial increase in left upper lobe heterogeneous consolidation and new peripheral areas of heterogeneous opacity are very suggestive of worsening pneumonia and septic emboli or multiple pulmonary infarctions. There may be a mild component of pulmonary edema due to volume overload reflected in mild increase in both heart size and caliber of mediastinal veins. Small left and small to moderate right pleural effusion are unchanged.

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

Heart size and mediastinum are unchanged. There is slight interval increase in left pleural effusion. There is minimal increase in left mid lung opacity above the fluid and unchanged appearance of the right lower lobe opacity. Overall no substantial change since previous examination demonstrated, but developing pneumonia in particular in the left mid lung cannot be excluded and reassessment with chest radiograph in 24 hr is recommended. .

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

Interval placement of endotracheal tube with tip terminating 2 cm above the carina. This could be withdrawn a few centimeters for standard positioning. Nasogastric tube terminates in the stomach. Lung volumes are low. Cardiac silhouette is within normal limits in size. Multifocal linear areas of atelectasis are present in the right perihilar, right infrahilar and left retrocardiac area. No significant pleural effusion and no visible pneumothorax.

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

AP radiograph of the chest was compared to ___. The ET tube tip is 5.5 cm above the carina. The NG tube tip is in the stomach. Heart size and mediastinum are stable. Bibasal areas of atelectasis are present. Left pleural effusion is noted. No evidence of pneumothorax is present.

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

Compared to chest radiographs ___ through ___. There has been no appreciable change since ___ in borderline interstitial edema in the left lung. Atelectasis at the right base is improved. Pleural effusions are presumed, but not substantial. Heart size is normal. Widening of the upper mediastinum is stable, since at least ___. Left jugular line ends at the origin of the SVC. No pneumothorax.

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

Moderate cardiomegaly, mediastinal venous engorgement, and bilateral pleural effusions are stable since ___. Mild pulmonary edema is new. There is no pneumothorax. Bibasilar atelectasis is severe, particularly on the left. Right PIC line ends in the region of the superior cavoatrial junction. .

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

DESPITE THE PRESENCE OF. 2 RIGHT PLEURAL DRAINAGE CATHETERS, MODERATE RIGHT PLEURAL EFFUSION HAS INCREASED. NO PNEUMOTHORAX. INCREASING PULMONARY VASCULAR CONGESTION SUGGESTS THERE MAY BE A COMPONENT OF VOLUME OR CARDIAC FUNCTION RELATED PLEURAL EFFUSION. BORDERLINE CARDIOMEGALY STABLE. LEFT PLEURAL EFFUSION SMALL IF ANY. ANGULATION OF THE OBLIQUELY ORIENTED LARGE RIGHT PLEURAL DRAINAGE TUBE MAY HINDER DRAINAGE. . NO PNEUMOTHORAX.

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

Left PIC line ends at a level 8 cm below the carina and would need to be withdrawn 4 cm to reposition it in the low SVC, if desired. Lungs are clear. There are no findings to suggest pneumonia. Heart size is normal. No pleural abnormality.

chest x-ray; 'No Finding'

AP single view of the chest has been obtained with patient in upright position. Comparison is made with the next preceding portable chest examination obtained one hour earlier during the same day. During the interval, left-sided chest tube has been removed. The chest findings are unchanged and no pneumothorax has developed.

chest x-ray;

Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion. Right supraclavicular catheter tip is in the lower SVC.

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

Cardiac pacemaker. Shallow inspiration accentuates heart size, pulmonary vascularity. Small left pleural effusion or thickening, similar. Previous tiny pleural effusion has resolved. Heart size has decreased. Left basilar opacities have nearly resolved. Small area of new right basilar opacity, likely atelectasis, consider pneumonitis in the appropriate clinical setting.

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

Compared to chest radiographs ___ through ___. The severe infiltrative pulmonary abnormality, substantially worse in the right lung, is unchanged over several days. Small pleural effusions are new. Heart size top- normal. No pneumothorax. Left PIC line ends close to the superior cavoatrial junction.

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

An ET tube terminates 5 cm above the carina in appropriate location. A right-sided PICC line terminates in the mid SVC. The cardiomediastinal silhouettes are within normal limits. The bilateral hila are unremarkable. Focal opacity in the left mid lung is concerning for pneumonia. Diffuse mild interstitial prominence of the central predominance is suggestive of pulmonary vascular congestion possible early pulmonary edema. Right lower lobe opacities could represent atelectasis and or pneumonia. Partially visualized is lower thoracic and lumbar spine spinal fusion hardware. There is no pneumothorax or pleural effusion.

chest x-ray; 'No Finding'

Cardiac size is normal. The lungs are clear. There is no pneumothorax or pleural effusion.

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

AP chest compared to ___: Right upper and left perihilar consolidation have improved relative to ___, but right mid and lower lung consolidation have definitely worsened. Extent of left lower lobe consolidation is stable since ___. Small bilateral pleural effusions are unchanged. Heart size is normal, and there is no mediastinal vascular engorgement. Condition of the pulmonary circulation is obscured by extensive consolidation. ET tube and left jugular line and nasogastric drainage tube are in standard placements respectively. No pneumothorax.

chest x-ray; 'Support Devices'

Portable upright chest radiograph excludes the right costophrenic angle. An NG tube is in place, the tip of which is superimposed upon the expected region of the body of the stomach. Note is made of an intrathoracic stomach fundus, better appreciated on CT performed same day, new since ___. The lungs are clear. The cardiac silhouette is normal in size, the mediastinal contours are normal.

chest x-ray;

The patchy density at the right base is slightly less pronounced than on the earlier study. There are no new areas of consolidation. There is no pneumothorax or CHF.

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

Since the prior radiograph performed on ___, there has been interval removal of the right-sided chest tube. No pneumothorax is seen. There is bibasilar atelectasis. Bilateral pleural effusions, right greater than left. No focal consolidation is seen within the well aerated portions of the parenchyma. Heart size is again noted to be enlarged. Median sternotomy wires are intact. Right internal jugular introducer is unchanged in position.

chest x-ray; 'No Finding'

In comparison with the earlier study of this date, there has been re-expansion of the right upper lobe following bronchoscopy. Otherwise no change.

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

ET tube tip is 4.3 cm above the carinal. Central venous line tip is at the level of cavoatrial junction. Widespread parenchymal opacities are present. No pleural effusion or pneumothorax increase in the interim demonstrated

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

Patient has been extubated. Left midlung consolidation has not changed significantly since the prior study. Mild pulmonary edema may be slightly improved. There is no pleural effusions or pneumothorax. No new focal consolidations are identified. The cardiomediastinal silhouette is unchanged.

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

Nasogastric tube terminates below the diaphragm. Heart size is normal, and lungs are clear.

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

There has been removal of the feeding tube. The left-sided PICC line has the distal lead tip at the distal SVC. Cardiomediastinal silhouette is within normal limits. There are no focal consolidations, pleural effusion, or pulmonary edema. There are no pneumothoraces.

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

In comparison with the study ___ ___, there is little change in the opacification at the right base consistent with aspiration or infectious pneumonia. The cardiac silhouette appears within normal limits at this time without appreciable vascular congestion or pleural effusion.

chest x-ray; 'Edema'

1) Interval removal of lines and tubes. No pneumothorax detected. 2) Mild interstitial edema and left lower lobe collapse and/or consolidation, both improved compared with ___.

chest x-ray; 'Lung Opacity'

In comparison with the study of ___, there are lower lung volumes. The cardiac silhouette is within normal limits and there is no evidence of acute pneumonia, vascular congestion, or pleural effusion. Mild prominence of interstitial markings again suggest some underlying chronic pulmonary disease.

chest x-ray; 'No Finding'

Again seen are a similar way of surgical ___ overlying the mid anterior mediastinum. Post-surgical mediastinal widening is similar as compared to one day ago, with stable extent of moderate bilateral pulmonary edema. The Swan-Ganz catheter is in expected position. Bilateral mediastinal drains and a left chest tube are stable in location. There is no pneumothorax or large pleural effusion.

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

As compared to the previous radiograph, the lung volumes have slightly increased, with a subsequent reduction of the bilateral pre-existing pleural effusions that are more extensive on the right than on the left. On today's image, small pleural effusions bilaterally persist. There are signs of mild pulmonary edema. Has overall decreased in severity since the prior examination. Unchanged moderate cardiomegaly, the left PICC line has been slightly pulled back, the tip is now located at the level of the superior SVC.

chest x-ray; 'No Finding'

Portable single AP chest radiograph was obtained. The patient is status post median sternotomy and CABG. The cardiomediastinal silhouette, hilar contours are stable. There is no pleural effusion or pneumothorax.

chest x-ray; 'No Finding'

The heart size is normal. Mediastinal and hilar contours are unremarkable. Lungs are clear. No pleural effusion, pulmonary vascular congestion or pneumothorax is present. There are no acute osseous abnormalities.

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

Portable AP chest radiograph demonstrates a left-sided PICC tip terminating and in the right atrium. There is no pneumothorax. The visualized lung the lungs are clear. The right costophrenic sulcus is not imaged. The cardiomediastinal silhouette is normal.

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

In comparison with the earlier study of this date, there has been placement of an endotracheal tube with its tip approximately 4 cm above the carina. The right and left basilar opacifications are less prominent at this time. Huge enlargement of the cardiac silhouette process as well as aortic graft.

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

In comparison to the chest radiograph obtained 3 days prior, there has been interval advancement of the Dobhoff tube into the small bowel and outside the field of view. A moderate, right pleural effusion has increased with substantial, adjacent, right middle and lower lobe compressive atelectasis. Previously noted right upper lobe consolidation has completely resolved. Left pleural effusion small, if any. Lungs otherwise well expanded and clear without focal consolidation.

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

Single frontal view of the chest demonstrates stable left pectoral cardiac pacer/AICD with similarly distributed leads and unchanged Dobbhoff tube with weighted tip extending into the stomach. A right internal jugular approach central venous catheter sheath demonstrates stable high positioning. Large right pleural effusion is redemonstrated, with similar distribution of multifocal bilateral consolidations, which mask underlying cavitations seen on CT dated ___. Stable perihilar vascular engorgement and cardiomediastinal prominence suggest a component of concurrent pulmonary edema.

chest x-ray; 'Pneumonia'

Compare to ___, lung volumes are low, accentuating the heart size and interstitial opacities. Bibasilar opacities obscuring the diaphragms are likely due to atelectasis, though pneumonia cannot be excluded. Small left pleural effusion is likely. The mediastinum and the hilar contours are unremarkable. Left-sided VP shunt is seen.

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

Exclusion of lung apices limits evaluation for apical pneumothorax. With this limitation in mind, no gross pneumothorax is evident. Endotracheal tube terminates 6 cm above the carina, nasogastric tube is coiled within the esophagus with distal tip directed cephalad at approximately the T8 vertebral body level, and this finding has been communicated by telephone to Dr. ___ on ___ at 9 a.m. at the time of discovery. Cardiomediastinal contours are stable in appearance. Bilateral, asymmetrically distributed predominantly perihilar airspace opacities are again demonstrated, worse on the right than the left. Since ___, the right-sided opacities have slightly improved, and the left have worsened. Differential diagnosis includes aspiration pneumonia (given history of seizure) and asymmetrical pulmonary edema.

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

As compared to the previous radiograph, no relevant change is seen in extent of the known left pleural effusion, the moderate cardiomegaly, the right pleural effusion as well as the areas of parenchymal opacities observed over both lungs. No new parenchymal opacities. No pneumothorax.

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

In comparison with the study of earlier in this date, there has been placement of a nasogastric tube with the tip extending to the lower body of the stomach. Right PICC line again extends well into the right atrium. Little change in the appearance of the heart and lungs.

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

In comparison with the study of ___, there is little change. Low lung volumes may account for some of the prominence of the transverse diameter of the heart. No vascular congestion or pleural effusion or acute focal pneumonia. There may be mild atelectatic changes at the bases. Of incidental note is substantial dilatation of the visualized bowel.

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

In comparison with the study of ___, the monitoring and support devices remain in place with the side hole of the nasogastric tube at or slightly distal to the esophagogastric junction. There is mild fullness of the pulmonary vessels raising the possibility of some elevated pulmonary venous pressure. Mild basilar atelectatic changes are seen especially on the right, where there is poor definition of the costophrenic angle and possible small pleural effusion.

chest x-ray; 'No Finding'

Semi-erect AP views of the chest were obtained. There are low lung volumes. The right costophrenic angle is hazy and cannot exclude a small pleural effusion. The cardiomediastinal silhouette is unchanged. There is no focal consolidation or pneumothorax.

chest x-ray; 'No Finding'

AP portable upright view of the chest. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. There is widening of the left acromioclavicular joint which could reflect chronic AC joint separation.

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

Single portable frontal chest radiograph demonstrates hypoinflated lungs with crowding of vasculature and bilateral lower lobe atelectasis. Retrocardiac opacity with trace pleural effusion. Persistent elevation of left hemidiaphragm. Heart size, mediastinal contour, and hila are otherwise unremarkable. Limited assessment of the upper abdomen is within normal limits.

chest x-ray; 'No Finding'

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

chest x-ray; 'Fracture'; 'Pneumothorax'

There is a small left apical pneumothorax. There is no right pneumothorax. Heterogeneous opacities bilaterally, particularly along the left heart border may represent atelectasis or sequela of contusion or potentially edema. Minimally displaced left fifth, sixth, and seventh rib fractures are noted. Right posterior seventh rib fracture is also mildly displaced. Heart size and mediastinal contours are within normal limits. Planning of the left AC joint may be chronic.

chest x-ray; 'No Finding'

Patient is status post median sternotomy. Chronic changes/ eventration of the right hemidiaphragm are stable and there is stable relative decrease in volume of the right lung as compared to the left. . No new focal consolidation is seen. There is no pleural effusion or pneumothorax. The cardiac and mediastinal silhouettes are stable. No pulmonary edema is seen.

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

In comparison with the study of ___, the patient has taken a slightly better inspiration. Monitoring and support devices remain in place. The degree of basilar opacification is less than on the previous study.

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

Portable AP radiograph of the chest was reviewed in comparison to ___. The appearance of the Dobbhoff tube tip is most likely post-pyloric. The right PICC line tip is most likely at the level of cavoatrial junction. Bilateral pleural effusions and bibasilar areas of atelectasis are present. There is no evidence of pneumothorax.

chest x-ray; 'Fracture'

The cardiomediastinal and hilar contours are within normal limits. The lungs show no consolidation or overt evidence of pulmonary edema. Retrocardiac opacity medially is compatible with hiatal hernia. Old appearing left upper rib fractures are present. There are also fractures of right upper ribs, including posterior right ___ and 6th ribs, likely old, but not clearly seen on the prior chest radiograph. Correlate clinically for acuity. There is no large pleural effusion or pneumothorax.

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

Right mid lung atelectasis have improved. Bibasilar atelectasis larger on the left side are grossly unchanged allowing the difference in inspiratory effort. Small right effusion is stable. Cardiomediastinal silhouette is unchanged.

chest x-ray; 'Pleural Effusion'

As compared to prior chest radiograph from ___, small bilateral pulmonary effusions have resolved. There is no overt pulmonary edema. The heart is top normal in size. A left-sided AICD/pacemaker device is noted with leads terminating in the right atrium and right ventricle, expected locations. Patient is status post median sternotomy and CABG. There is diffuse demineralization of the osseous structures.

chest x-ray; 'No Finding'

Single portable view of the chest. No prior. The lungs are clear. There is no consolidation or pulmonary vascular congestion. The cardiomediastinal silhouette is within normal limits for technique. Osseous and soft tissue structures are unremarkable.

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

Portable AP chest radiograph was reviewed in comparison to ___ and CT of the pancreas obtained ___. There is new left lower lobe consolidation currently seen, and to a lesser extent right lower lobe consolidation, concerning for infectious process or aspiration. The patient also is in mild interstitial pulmonary edema. There is no pleural effusion or pneumothorax demonstrated.

chest x-ray; 'Support Devices'

There is no focal consolidation, pleural effusion, pneumothorax, or pulmonary edema. The cardiomediastinal silhouette is within normal limits. A paucity of apical vasculature suggests emphysema. There may be a small hiatal hernia. The tracheostomy tube and right IJ central venous catheter in good position.

chest x-ray; 'No Finding'

Multifocal diffuse parenchymal opacities in both lungs worse since ___, have not significantly changed since ___. No evidence of central lymphadenopathy or pleural effusions. There is no cardiomegaly or interstitial thickening to suggest pulmonary edema.