Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post sternotomy . A dual - lead pacemaker / ICD device appears unchanged with leads terminating in the right atrium and ventricle , respectively , without change . The heart appears mildly enlarged . The aorta shows unfolding and mural calcification . Hemidiaphragms are flattened . There is probably a small pleural effusion on the right and a slightly larger one on the left , as well as increased thickening along the minor fissure . Although this finding suggests a component of fluid overload , focal opacities projecting over the right lower and left upper lungs are most suggestive of pneumonia with areas of spared lung elsewhere . Biapical pleural thickening is unchanged . Bony structures are unremarkable .
    OUTPUT:
    
Findings most suggestive of multifocal pneumonia . Small pleural effusions .