FINDINGS:
Single AP upright portable view of the chest was obtained.  The
 lungs remain hyperinflated, consistent with chronic obstructive pulmonary
 disease.  The cardiac silhouette is enlarged.  Evidence of hiatal hernia is
 again seen.  The aorta is calcified and tortuous.  There is mild pulmonary
 vascular congestion.  There is blunting of the right costophrenic angle which
 may be due to overlying soft tissue, though a small pleural effusion cannot be
 excluded.  Bibasilar atelectasis is seen without discrete focal consolidation.

IMPRESSION:
1.  Cardiomegaly and minimal pulmonary vascular congestion.  Blunting of the
 right costophrenic angle may be due to overlying soft tissue, although a trace
 effusion cannot be excluded.
 2.  Hiatal hernia.