IMPRESSION:
In comparison with the study of , the cardiac silhouette is more
 prominent.  Continued indistinctness of pulmonary vessels is consistent with
 elevated pulmonary venous pressure.  Retrocardiac opacification most likely
 reflects atelectatic changes and possible small effusion.  Again, in the
 appropriate clinical setting, it would be difficult to unequivocally exclude
 superimposed pneumonia, especially in the absence of a lateral view.