FINDINGS:
There is no focal consolidation, effusion, or pneumothorax.  There is mild
 pulmonary vascular congestion and trace interstitial edema.  Cardiomegaly is
 moderate.  Elevation of the right hemidiaphragm anteriorly is severe and
 chronic.  Imaged osseous structures are intact.  No free air below the right
 hemidiaphragm is seen.  Sternal wires, valve replacement, left chest cardiac
 device with 2 leads, and mitral annular calcifications appear similar compared
 to prior.

IMPRESSION:
Mild pulmonary vascular congestion and trace interstitial edema.