FINDINGS:
Frontal and lateral views of the chest.  Left chest wall dual-lead
 pacing device is again seen with tips in the right ventricle and coronary
 sinus.  There is blunting of the posterior costophrenic angles compatible with
 small effusions as seen on prior.  There is a hazy left basilar, retrocardiac
 opacity which was not clearly seen on most recent prior exam and could
 represent developing infection.  Elsewhere, the lungs are clear.  The
 cardiomediastinal silhouette was unchanged.  No acute osseous abnormalities.

IMPRESSION:
Small persistent bilateral effusions.  Subtle left basilar
 opacity which could represent infection in the proper clinical setting.