FINDINGS:
Pleural this a portable upright technique the mediastinum is widened it's
 unclear how much of this is projectional Swan-Ganz catheter tip is in the
 pulmonary outflow tract.  The heart is enlarged is pulmonary vascular
 redistribution is volume loss at both bases and bilateral pleural effusions
 compared to the prior study fluid status is worse.

IMPRESSION:
1.  Wide mediastinum, some of which could be projectional
 
 2.  Worsened fluid status.