IMPRESSION:
1.  Right internal jugular Swan- catheter with its tip in the pulmonary
 outflow tract.  Endotracheal tube has a tip at the thoracic inlet.  There is a
 nasogastric tube seen coursing below the diaphragm with the tip not
 identified.  Mediastinal drains and left basilar chest tube remain in place.
 2.  When compared to the prior study in this patient status post median
 sternotomy for CABG, there is interval widening of the mediastinal contours,
 which would be concerning for mediastinal bleeding.  There is likely a small
 left effusion.  Lung volumes are slightly lower with crowding of pulmonary
 vasculature.  No evidence of pulmonary edema.  No large pneumothorax is seen
 on this supine radiograph.  Small left effusion.  Results of this examination
 were discussed with the patient's nurse,  on  at 10:06 a.m.