IMPRESSION:

1.  The heart remains mildly enlarged but unchanged. Mediastinal contours are within normal limits. No evidence of pneumothorax. Interval improvement in aeration with improving mild pulmonary and interstitial edema.
2.  Dual-lead left-sided pacemaker with its leads terminating over the expected location of the right atrium and right ventricle respectively. Left internal jugular central line has its tip in the proximal superior vena cava. Endotracheal tube continues to have its tip approximately 3 cm above the carina. Nasogastric tube seen coursing below the diaphragm with the tip not identified. Probable small layering right effusion. More patchy opacity at the left base may reflect a combination of compressive
