IMPRESSION:
Compared to chest radiographs  through .
 
 Moderate pulmonary edema and moderate right pleural effusion have worsened. 
 Mediastinal widening is due to vascular engorgement, indicating biventricular
 decompensation.  No pneumothorax.
 
 Left jugular line ends in the upper SVC, ET tube in standard placement,
 nasogastric drainage tube passes into the stomach and out view.
 
 Note is made of extensive central lymph node calcification suggesting
 sarcoidosis, and prior documentation of moderate pericardial effusion on a
 chest CT .