FINDINGS:
PA and lateral views of the chest. A small to moderate right pleural
 effusion is new compared to most recent study.  A right lower lobe opacity has
 persisted since  may represent pneumonia.  Left lung is clear. 
 There is no left pleural effusion.  Aortic and mitral valve replacement and
 tricuspid annuloplasty are seen.  Sternotomy wires are in place.  No
 pneumothorax.  Moderate cardiomegaly is unchanged.  The mediastinal and hilar
 contours are normal.

IMPRESSION:
1.  Increased right pleural effusion, now small to moderate.
 2.  Right lower lobe opacity may represent pneumonia.  The other opacities in
 the right lung have resolved.