increased bilateral pulmonary opacities in the setting of pulmonary vascular congestion and cardiomegaly. the appearance is most consistent with edema, but clinical correlation is recommended for symptoms of infection. follow up radiograph is recommended after diuresis or dialysis to assess response. findings and recommendations were discussed with <unk> by <unk> <unk> by phone at <time> a.m. on <unk> at the time of initial review of the study.