IMPRESSION:
1.  Right subclavian PICC line and right internal jugular central line are
 unchanged.  Lung volumes remain low.  No focal airspace consolidation is seen
 to suggest pneumonia.  No pleural effusions or pneumothorax.  The heart
 remains enlarged with left ventricular prominence, most likely representing
 cardiomegaly, although a pericardial effusion cannot be entirely excluded. 
 Clinical correlation is advised.  Mediastinal contours are unchanged. No
 pulmonary edema.