FINDINGS:
Left-sided single-lead pacer is unchanged in position.  Severe
 cardiomegaly appears progressed since .  There is mild prominence
 of the central pulmonary vasculature, however, without interstitial pulmonary
 edema.  Right upper lung nodule appears larger than on prior exam. Lungs are
 otherwise clear.  There is no pleural effusion or pneumothorax. 
 Dextroscoliosis is redemonstrated.

IMPRESSION:
No acute cardiopulmonary abnormality.  Cardiomegaly has
 progressed since .  Right upper lung nodule appears larger
 than on prior exam and dedicated nonurgent CT suggested.