FINDINGS:
Comparison is made to previous study from .
 
 There is a right IJ central line with distal lead tip in the right atrium. 
 This could be pulled back 3 cm for more optimal placement.  Heart size is
 prominent, but stable.  Mediastinal wires are seen.  There is some atelectasis
 at the lung bases without signs for overt pulmonary edema.  A small left-sided
 pleural effusion is seen.  There are no pneumothoraces.