IMPRESSION:
1.  Opacity at the right base is thought to represent a hiatal hernia, which
 is now completely fluid-filled.  If desired, lateral view could help to
 confirm this.
 
 2.  New minimal patchy opacity and blunting of the left costophrenic angle.
 
 3.  COPD, cardiomegaly, and enlarged left and ? right pulmonary hila,
 consistent with pulmonary hypertension.
 
 4.  No evidence of CHF.