Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral views of the chest were obtained . Dual - lead left - sided pacemaker is seen with leads extending to the expected locations of the right atrium and right ventricle . Patient is status post median sternotomy . The cardiac and mediastinal silhouettes are stable . Mild - to - moderate pulmonary edema is again seen . Relative slightly more confluent opacity projecting over the right lower lung most likely relates to prominent vascular structures rather than infection . A trace left pleural effusion is difficult to exclude , however , there is no large pleural effusion . No evidence of pneumothorax is seen . Old right - sided rib fractures with pleural thickening are again seen .
    OUTPUT:
    
Persistent cardiomegaly and mild - to - moderate pulmonary edema which appears increased as compared to the prior study . Relative more confluent opacity at the right lung base most likely relates to confluence of vascular structures ; however , an underlying infectious process is not excluded in the appropriate clinical setting .