heart size at the upper limits of normal. allowing for this, no acute pulmonary process identified. no chf or pleural effusions. non-visualization of the clavicular companion shadows (normal soft tissue contour along the superior edge of the clavicles). while this may be an artifact due to overlying soft tissues, clinical correlation to exclude supraclavicular lymphadenopathy (which can be a source of nonvisualization of the companion shadow) is requested.