Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A right internal jugular venous catheter terminates in the upper right atrium . A dual - lead pacemaker / ICD device appears unchanged . The heart is mild to moderately enlarged . Allowing for differences in technique including lower lung volumes , the mediastinal and hilar contours appear likely unchanged including prominence of the aortopulmonary window suggesting perhaps enlargement of the main pulmonary artery . The aorta is tortuous and calcified . Blunting and hazy opacity in the left lower hemithorax and costophrenic sulcus suggests a small pleural effusion . There is no definite pleural effusion on the right . There is a mild interstitial abnormality suggesting mild pulmonary congestion . Scarring at each lung apex is probably unchanged .
    OUTPUT:
    
Central venous catheter terminating in the right upper atrium . Findings suggesting mild vascular congestion including a suspected new small left - sided pleural effusion ; no definite focal consolidation .