IMPRESSION:
AP chest compared to  through :
 
 Mediastinal venous engorgement is still severe but slightly improved compared
 to .  The same is true for severe cardiomegaly.  Bulging right
 heart contour is atypical for either right or left atrial enlargement, and at
 least lateral chest radiograph would be helpful to discriminate between the
 two.  There is no pulmonary edema or pleural effusion.  Right PIC line ends at
 the junction of brachiocephalic veins.  No pneumothorax.  Pleural effusion is
 minimal if any.