PORTABLE CHEST:Film is compared with the previous study. Horizontal linear densities are present just above the right hemi-diaphragm. The cardiac silhouette and left lung are within normal limits. No pulmonary congestion or effusion is seen. The aorta is calcified.

Impression: No significant change from 6/5/94. Probable localized fibrosis, right base, otherwise normal portable chest. V. Erburg, MD/ES/SC

SUPINE STUDY OF THE CHEST: was obtained in the department. There is a nasogastric tube in place. The tube appears to be coiled upon itself and the tube does not appear to extend beyond the mid-esophagus.

Impression: Nasogastric tube coiled in the mid-esophagus as discussed. G. Newstead, MD/KEN/RB

PORTABLE CHEST: A bedside study of the chest was obtained. The overall heart size is within normal limits allowing for semi-upright position. There is some elevation of the right lung base. No other abnormality is seen however.

Impression: Possible right lower lobe pneumonia. G.Newstead, MD/SUE/K

PORTABLE CHEST: AP supine study. 5:45PM. CVP line has been inserted. The tip appears to be satisfactorily located within the superior vena cava.

Impression: Satisfactory position of the CVP line. G. Newstead, MD/PK/KAY

PORTABLE CHEST: Overpenetrated study was obtained. Allowing for differences in technique, no significant interval change is seen. The position of the endotracheal tube and the CVP line appears satisfactory. Infiltrations at both lung bases, possibly inflammatory in nature, are again seen.

Impression: Bilateral lower lobe infiltrates. No significant interval change. G. Newstead, MD/KAY/KAY

PORTABLE CHEST: An AP supine view at 11:05 AM shows there is now a Udall catheter in good position in the superior vena cava. There is no change in the other tubes and catheters. The lung bases now may be somewhat congested.

Impression: Udall catheter in good position in the superior vena cava. Possibly some basilar pulmonary congestion. Otherwise no change. T.E. Hung, MD/CIND/DH

ELECTROCARDIOGRAM, 12 LEAD: Sinus tachycardia rate 120, PR 0.16, QRS .06, QT normal axis minus 10. Tracing is essentially similar to the previous one 6/7/94.

Impression: Again a suggestion of early left ventricular enlargement. O.R. VELIS, MD/DA

ELECTROCARDIOGRAM, 12 LEAD: Atrial fibrillation. Average ventricular rate 125, QRS 0.08, axis normal, PVBs present.

Impression: Compared with the previous EKG of 7/13/94, conduction is mostly normal except for rare right bundle branch block pattern beats. Atrial fibrillation is new. Suggest follow-up EKG. K. Salzseider, MD/DB

ELECTROCARDIOGRAM, 12 LEAD: Atrial fibrillation. Average ventricular rate 125, QRS 0.08, axis normal, PVBs present.

Impression: Compared with the previous EKG of 7/13/94, conduction is mostly normal except for rare right bundle branch block pattern beats. Atrial fibrillation is new. Suggest follow-up EKG. K. Salzseider, MD/DB

ELECTROCARDIOGRAM, 12 LEAD: Atrial fibrillation, variable to rapid ventricular response around 140 to 150. Compared with 7/15/94 there has been not much change in axis. R waves are taller now in 1, AVL and in the left precordial leads.

Impression: EKG remains abnormal, atrial fibrillation, rapid ventricular response, now evidence for a degree of left ventricular enlargement. E.C. Keene, MD/DA