FINDINGS:
The patient is status post median sternotomy and CABG.  Left-sided
 dual-chamber pacemaker device is noted with leads terminating in the right
 atrium and right ventricle.  Moderate to severe cardiomegaly is not
 substantially changed in the interval.  Mild pulmonary edema appears slightly
 worse from the previous exam.  No large pleural effusion or pneumothorax is
 seen.  Atelectasis is demonstrated in the lung bases.

IMPRESSION:
Slight interval worsening of mild pulmonary edema.  Similar moderate to severe
 cardiomegaly.