IMPRESSION:
AP chest compared to :
 
 Lung volumes are lower, and pulmonary and mediastinal vasculature are more
 engorged, with slight increase in interstitial edema, all pointing toward
 cardiac decompensation.  There may have been an increase in the small left
 pleural effusion, best evaluated on the lateral projection.  There is no
 pneumothorax.  Heart size is top normal, larger today than yesterday.  No
 pneumothorax.