FINDINGS:
There is significant rightward rotation on the current radiograph.  Allowing
 for changes due to this, the cardiomediastinal silhouettes are stable from
 prior exam.  There is a mildly tortuous thoracic aorta.  There is a poor
 inspiratory effort, and low lung volumes.  Within this limitation, the lungs
 are clear.  There is no evidence of pulmonary vascular congestion.  There is
 no evidence of pneumothorax or pleural effusion.

IMPRESSION:
No acute cardiopulmonary process.