IMPRESSION:
Since the prior study there has been interval improvement in pulmonary
 vascular congestion .  Right pleural effusion is substantial, unchanged
 recruitment.  Left pleural effusion is present.  A left pleural effusion is
 most likely moderate. There is no evidence of pneumothorax.  There is left
 retrocardiac opacity most likely representing a combination of pleural
 effusion and atelectasis.