MEDICORE REGIONAL HOSPITAL Radiology & Imaging Department Imaging Report — Confidential ================================================================ Report ID: IMG-2026-08-04-0912 Patient ID: P-1001 Full Name: James R. Mitchell Exam: Chest X-Ray (PA + Lateral) Modality: Digital Radiography (DR) Date: August 4, 2026 — 09:15 AM Radiologist: Dr. Sunita Kapoor, FRCR (#RD-0082) Referrer: Dr. Priya Nambiar, MD ================================================================ CLINICAL INDICATION: Shortness of breath, fatigue, borderline elevated BNP. Rule out cardiomegaly or pulmonary oedema. TECHNIQUE: PA and lateral projections obtained in full inspiration. Adequate penetration and positioning. FINDINGS: Cardiac Silhouette: Cardiothoracic ratio: 0.54 (upper limit of normal is 0.50) MILDLY ENLARGED — suggests early cardiomegaly. Lung Fields: Mild haziness in both lower zones consistent with early pulmonary oedema / venous congestion. No consolidation, effusion, or pneumothorax identified. Costophrenic angles: partially blunted bilaterally (fluid). Mediastinum: Upper mediastinum not widened. No hilar adenopathy. Bones: No acute bony injury. Mild degenerative changes at thoracic spine. Soft Tissues: Unremarkable. IMPRESSION: 1. Mild cardiomegaly — correlate with echocardiogram (ordered). 2. Early signs of pulmonary venous congestion — monitor closely. 3. No acute pneumonia or pneumothorax. RECOMMENDATION: Urgent echocardiogram within 48 hours. Serial CXRs if symptoms worsen. Electronically signed: Dr. Sunita Kapoor, FRCR — 2026-08-04 11:30