MEDICORE REGIONAL HOSPITAL
Radiology & Imaging Department
Imaging Report — Confidential
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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
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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