Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest were provided . Dual - lead pacemaker is unchanged with pacer pack residing in the chest wall and lead tip residing in the expected location of the right atrium and right ventricle . Midline sternotomy wires and changes from prior CABG again noted . The patient is kyphotically positioned , limiting evaluation . Scoliotic deformity is again seen . Increased vague opacity in the upper lungs is increased from prior exam and likely reflects loculated pleural collections as seen on the lateral view . There is also mild interstitial edema with cardiomegaly again seen . Clips are noted in the left axilla .
    OUTPUT:
    
Increased density in the upper lungs bilaterally likely represent increasing loculated pleural collections / pseudotumor . Mild interstitial edema is redemonstrated . Given that the patient is symptomatic , consider CT to better assess and to guide decision making for possible intervention .