FINDINGS:
As similar to multiple prior exams, there is a relative hazy
 density in the bilateral hilar regions with pulmonary vascular indistinctness.
 The hemidiaphragms are not well defined.  The cardiomediastinal silhouette is
 markedly enlarged with widening superiorly and an enlarged cardiac silhouette
 inferiorly.  The patient's chin overlies the lung apices, limiting the
 evaluation.  No gross pneumothorax is seen.

IMPRESSION:
Limited study due to body habitus.  There are low lung volumes
 which result in bronchovascular crowding, but beyond that there is likely
 moderate pulmonary edema presumably cardiogenic in etiology.  There may also
 be small bilateral pleural effusions.