                                 FINAL REPORT
 REASON FOR EXAMINATION:  Evaluation of the patient with severe COPD and
 decreased ejection fraction with dyspnea and left basilar rales.
 
 PA and lateral upright chest radiographs were reviewed in comparison to .
 
 There is interval progression of left mid-lower lung opacities that appear to
 be more pronounced than on the prior chest CT from .  In
 conjunction with severe emphysema, they most likely represent interval
 development of infectious process/aspiration.  There is minimal vascular
 engorgement, but no overt pulmonary edema.  Small amount of left pleural
 effusion/pleural thickening is unchanged.  Heart size is enlarged, unchanged. 
 Post-sternotomy wires are unremarkable.  The pacemaker defibrillator leads
 terminate in the expected location of right atrium, right ventricle, and left
 ventricle epicardial leads.
