FINDINGS:
The patient is status post median sternotomy and CABG.  The cardiac and
 mediastinal silhouettes are stable with the cardiac silhouette persistently
 enlarged.  Two lead left-sided pacemaker is again seen, unchanged in position.
 There are slightly low lung volumes and there is persistent mild elevation of
 the right hemidiaphragm.  Slight blunting of the right costophrenic angle is
 stable.  Stable right base scarring is again seen.  There is no evidence of
 pneumothorax.  No overt pulmonary edema is seen.  There may be mild pulmonary
 vascular congestion.

IMPRESSION:
Stable cardiomegaly with possible mild pulmonary vascular congestion, without
 overt pulmonary edema.