FINDINGS:
The heart size is at the upper limits of normal os slightly
 enlarged, increase in size compared to prior exam.  The mediastinal contours
 demonstrate calcified atherosclerotic disease of the aortic knob, similar to
 prior exam.  Perihilar opacities are present as well as an engorged appearance
 of the pulmonary vasculature and interstitial edema.  No definite large
 pleural effusion is present, and there is no pneumothorax.

IMPRESSION:
Cardiomegaly and pulmonary edema, concerning for heart failure.