FINDINGS:
The tip of the balloon pump overlies the inferior edge of the aortic arch,
 slightly high.  A right IJ Swan-Ganz catheter is present, tip over proximal
 right pulmonary artery.
 
 Heart size is unchanged.  The vascular congestion and moderate pulmonary edema
 appears slightly worse in comparison to the prior exam.  There is probable
 trace fluid at the right cardiophrenic angle. The extreme left costophrenic
 angle is excluded from the film.  No gross effusion is seen on either side.

IMPRESSION:
1. Aortic balloon pump overlying the inferior edge of the aortic arch,
 slightly high.  Clinical correlation regarding possible retraction into the
 descending aorta is requested.
 2. Vascular congestion and moderate pulmonary edema, which appears slightly
 worse compared to earlier the same day.