FINDINGS:
Heart size is normal.  Mediastinal and hilar contours are unchanged, with mild
 tortuosity of the thoracic aorta again noted.  The pulmonary vascularity is
 normal.  The lungs are clear.  No pleural effusion or pneumothorax is present.
 There are no acute osseous abnormalities.

IMPRESSION:
No acute cardiopulmonary process.