FINDINGS:
Two right-sided chest tubes are present, similar in configuration to the prior
 film.
 
 The appearance of the right lung is similar, allowing for technical
 differences.  Again seen is a large right effusion, with underlying collapse
 and/or consolidation.  No pneumothorax is detected.
 
 The patient is status post sternotomy, with marked enlargement of the
 cardiomediastinal silhouette.  As before, the right-sided heart border is
 obscured by the opacities at the right lung base, but no significant interval
 change is detected in cardiomediastinal  size or morphology.
 
 The degree of retrocardiac opacity has improved. The left  lung is otherwise
 grossly clear. There is minimal blunting of left costophrenic angle,
 unchanged.
 
 On the left, they areas upper zone redistribution, but no overt CHF.  Vascular
 plethora in the right upper zone is likely secondary to compression of the
 right lung by the effusion.

IMPRESSION:
Large right effusion with underlying collapse and/or consolidation.  This
 together with other findings in the chest are essentially unchanged compared
 with .  Possible slight interval improvement in left lower lobe
 collapse and/or consolidation.  No pneumothorax detected.