FINDINGS:
Again seen and bilateral pleural effusions with platelike atelectasis of the
 left mid lung, relatively unchanged compared to previous radiographs.  No
 vascular congestion.  No pneumothorax is seen. The cardiac silhouette is
 enlarged but unchanged, and mediastinal silhouette is unchanged. Median
 sternotomy wires are again noted.  Left pectoral pacer with leads in the right
 atrium and right ventricle.  Right PICC tip in unchanged position.

IMPRESSION:
No significant change in the bilateral pleural effusions since .
 Platelike atelectasis in the left mid lung again seen.  Enlarged cardiac
 silhouette.