IMPRESSION:
AP chest compared to  through :
 
 Large right pneumothorax has increased further.  There is only mild leftward
 mediastinal shift, not changed appreciably since .  Also unchanged is
 relative equalization of the heights of the hemidiaphragms, so if pressure in
 the right hemithorax by virtue of pneumothorax is hemodynamically significant,
 it has not changed in more than 36 hours.  Clinical correlation is essential. 
 Left lung is clear.  Heart is not enlarged.
 
 Findings were reported after review of subsequent chest radiograph available
 at the time of this dictation.