FINDINGS:
Heart size remains mild to moderately enlarged. The mediastinal and hilar
 contours are unchanged with a small hiatal hernia again noted.  There is mild
 pulmonary vascular congestion. There are small bilateral pleural effusions,
 not changed from the prior study. Retrocardiac patchy opacity may reflect
 atelectasis though infection is difficult to exclude. Hypertrophic changes are
 again noted within the thoracic spine. No subdiaphragmatic free air is
 identified.

IMPRESSION:
Mild pulmonary vascular congestion and small bilateral pleural effusions.
 Retrocardiac atelectasis, though infection cannot be completely excluded.