FINDINGS:
Heart size is moderately enlarged.  Mediastinal contours unremarkable. 
 Hyperinflation of the lungs is suggestive of underlying chronic obstructive
 pulmonary disease.  Large left pleural effusion is noted with retrocardiac
 opacity likely reflective of atelectasis.  Infection is not excluded.  No
 pneumothorax is noted.  Mild pulmonary vascular congestion may be present. 
 The right lung is grossly clear.  No acute osseous abnormalities seen. 
 Multiple left axillary clips are demonstrated.

IMPRESSION:
Large left pleural effusion with left basilar opacity likely reflective of
 atelectasis though infection is not excluded.  Probable mild pulmonary
 vascular congestion.