FINAL REPORT
 PA AND LATERAL CHEST FILM
 
 CLINICAL INDICATION:  ___-year-old with pneumonia, new aspiration event,
 possible apical pneumothorax on prior chest film.  Assess for interval change.
 
 Comparison is made to the patient's prior study of ___ at ___.
 
 PA and lateral views of the chest ___, at ___ are submitted.
 
 IMPRESSION:  
 
 In addition, the perihilar vasculature is somewhat more prominent and indistinct which suggests a component of superimposed perihilar edema.
 There is blunting of the costophrenic angles which may represent chronic pleural thickening or small effusions.
 There is diffuse air space process with more focal consolidation again seen in the left mid lung and at the lung bases.
 Left-sided pacer is again seen with three leads terminating over the expected location of the right atrium and right ventricle, respectively.
 In addition, the lungs remain hyperinflated and there is parenchymal distortion and apical bullous changes consistent with underlying emphysema.
 Overall, cardiac and mediastinal contours are stable.
 Heart remains enlarged most likely representing cardiomegaly.
 This is concerning for bilateral pneumonia/aspiration.
 No pneumothorax is seen.
