FINDINGS:
Left pectoral pacemaker leads end in the expected locations of the
 right atrium and right ventricle.  Mild opacity in the right mid lung is new
 from  and may represent developing infection in the appropriate clinical
 setting.  Pulmonary vasculature is within normal limits.  Heart size is
 normal.  The aorta appears slightly larger than in , which probably due to
 patient rotation.  There is no pneumothorax.  Blunting at the left
 costophrenic sulcus is similar to the prior study.  In the left lower lung, a
 1.8cm nodular opacity likely representing callus formation at a healing rib
 fracture.

IMPRESSION:
1.  Right mid lung opacity may represent early infection. Recommend repeat
 radiograph after treatment to document resolution.
 2.  Left lower lung nodule is probably callus formation at a healing rib
 fracture. Recommend shallow obliques for confirmation.
 3.  No evidence of congestive heart failure.
 
 Discussed with Dr.  at 12:07am .