FINDINGS:
AP upright and lateral views of the chest provided.  Vascular stents are noted
 in the left and right brachiocephalic vein. Calcifications in the left upper
 quadrant correspond with the spleen. Cardiomegaly is stable with interval
 increase in bilateral ground-glass opacity consistent with pulmonary edema.
 Subtle nodularity in the right lower lung raises potential concern for a
 superimposed pneumonia. No large effusion or pneumothorax is seen. The
 mediastinal contour is stable. Mild hilar engorgement is noted. Hyperdense
 appearance of the osseous structures are is consistent with renal
 osteodystrophy.  No free air below the right hemidiaphragm is seen.

IMPRESSION:
Cardiomegaly, mild edema, with possible superimposed pneumonia.