FINDINGS:
There is mild interstitial pulmonary edema in the setting of unchanged severe
 cardiomegaly. No pleural effusion is identified in the left. The right
 costophrenic angle is not clearly seen due to the enlarged heart. There is no
 pneumothorax. The left-sided by come out pacemaker is redemonstrated with
 leads in unchanged position.

IMPRESSION:
Interstitial pulmonary edema on the setting of stable severe cardiomegaly.