FINDINGS:
A small-to-moderate right pleural effusion has slightly increased in the
 interim.  A small left pleural effusion is perhaps slightly smaller compared
 to the prior exam.  Opacity in the lower lungs could be atelectasis of most
 concurrent pneumonia cannot be excluded.  No frank pulmonary edema or focal
 consolidation in the remaining aerated lung.  Heart size is mildly enlarged,
 unchanged.  Mediastinum is not widened.  Median sternotomy wires, replaced
 cardiac valve, dual lead cardiac device are unchanged.  Aortic knob
 calcifications are unchanged. No pneumothorax.  No acute osseous abnormality.

IMPRESSION:
Persistent bilateral pleural effusions, small to moderate on the right and
 small left with adjacent opacities which could be atelectasis versus
 concurrent pneumonia in the appropriate clinical scenario.