FINAL REPORT
 PA AND LATERAL CHEST OF ___
 
 COMPARISON:  Chest radiograph of ___ and CT exam of ___.
 
 FINDINGS:  There are no pleural effusions. Heart is upper limits of normal in size. There has been previous median sternotomy and coronary artery bypass surgery. Bones are demineralized, and there has been progression in severity of a compression deformity in the mid thoracic spine on the lateral view. Lungs are hyperexpanded, consistent with known emphysema on prior chest CT. A more confluent opacity has developed at the left lung base, predominantly in the retrocardiac region. Additionally, there are worsening reticular opacities at the bases, which may reflect progressive interstitial fibrosis or interstitial edema superimposed upon fibrotic opacities. Enlargement of the central pulmonary arteries is suggestive of pulmonary arterial hypertension.
 
 IMPRESSION:
 1.  Enlarged pulmonary artery suggestive of pulmonary arterial hypertension.
 
 2.  Emphysema.
 
 3.  Confluent left basilar opacity may reflect atelectasis, pneumonia or aspiration. Followup radiographs are recommended to document resolution.
 
 4.  Progressive basilar interstitial abnormalities, which may represent pulmonary fibrosis with or without superimposed acute interstitial edema.
