FINDINGS:
Since the prior study, there has been significant interval increase in
 bilateral perihilar and mid to lower lung opacities worrisome for moderate to
 severe pulmonary edema with possible increase in bilateral pleural effusions
 and overlying atelectasis.  Bibasilar opacities likely represent combination
 of pleural effusion and atelectasis, however, in the appropriate clinical
 setting underlying consolidation due to infection or aspiration not excluded. 
 Cardiac silhouette is difficult to actually assessed due to the adjacent
 basilar opacities.

IMPRESSION:
Interval increase in bilateral perihilar and mid to lower lung opacities
 worrisome for moderate to severe pulmonary edema and bilateral pleural
 effusions which may be increased.
 
 Bibasilar opacities likely represent combination of pleural effusion and
 atelectasis, however, in the appropriate clinical setting underlying
 consolidation due to infection or aspiration not excluded.