IMPRESSION:
Tracheostomy and right subclavian line tip are in unchanged appropriate
 positions.
 
 There is a interval increase in the cardiac silhouette as well as distension
 of the azygos vein, findings that might reflect volume overload or potentially
 pericardial effusion and correlation with echocardiography is required
 
 2 there is also interval development of vascular congestion that is consistent
 with interstitial pulmonary edema. Right basal opacity most likely represents
 a combination of atelectasis and pulmonary edema.  No interval increase in
 pleural effusion or pneumothorax demonstrated.
 
 Part of the lower lobe opacity demonstrated in the chest radiograph
 corresponds to pneumonia suspected on recent CT abdomen.