blunting of both posterior costophrenic angles likely reflects small effusions. patchy opacity at the right medial lung base may reflect an area of atelectasis, although pneumonia or aspiration should also be considered. the remaining lungs are clear. prominent perihilar vasculature and azygos fullness suggest a fluid replete state. no pulmonary edema or pneumothorax. heart is upper limits of normal in size. if pulmonary embolism remains of clinical concern, chest ctpa is more sensitive.