FINDINGS:
PA and lateral views of the chest provided.   Dual lead pacer is again seen
 with leads extending to the region the right atrium and right ventricle. There
 is mild cardiomegaly with moderate pulmonary edema. No large effusions or
 pneumothorax seen. Bony structures intact. No free air below the right
 hemidiaphragm.

IMPRESSION:
Mild cardiomegaly and moderate pulmonary edema.