Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A left - sided pacemaker / AICD device is noted with single lead terminating in the right ventricle . The patient is status post median sternotomy and mediastinal clips . Heart remains moderately enlarged . Mediastinal and hilar contours are unchanged with calcification of the thoracic aorta again noted . Worsening opacification within the left lower lobe is concerning for pneumonia or aspiration . Small bilateral pleural effusions persist . There is no pulmonary vascular engorgement . Minimal atelectasis in the right lung base is noted .
    OUTPUT:
    
Worsening opacity in the left lower lobe concerning for pneumonia or aspiration . Unchanged small bilateral pleural effusions .