FINDINGS:
PA and lateral chest radiographs.  There is persistent elevation of
 the right hemidiaphragm which is more pronounced than on priors.  Small right
 pleural effusion is new.  However, there is no evidence of pulmonary edema. 
 The heart size is normal.  Again noted is the abnormal contour of the right
 apex which may represent fibrotic changes.

IMPRESSION:
Small right pleural effusion in the setting of elevated right
 hemidiaphragm which has been present on prior exams but is slightly more
 pronounced.  If there is further concern for an underlying abnormality, chest
 CT can be considered.  However, no evidence of pulmonary edema.
 
 Findings were discussed by Dr.  with Dr.  by
 phone at 5:04 p.m. on .