FINDINGS:
A left pectoral pacemaker is unchanged with three leads in the
 right atrium, right ventricle, and coronary sinus, as before.  There has been
 interval removal of the endotracheal tube from .  The cardiac
 silhouette remains severely enlarged. Partial calcification of the aortic knob
 is redemonstrated.  The mediastinal contours are unchanged.  There is no
 pulmonary vascular congestion or interstitial edema.  A moderate right pleural
 effusion is appreciated on the lateral view with mild right basilar
 atelectasis.  There is no left pleural effusion.  No pneumothorax is seen.
 
 Diffuse dense calcification of the abdominal aorta is noted.

IMPRESSION:
1.  No pulmonary edema/vascular congestion.
 2.  Moderate right pleural effusion and mild right basilar atelectasis.