Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A left pectoral pacemaker is unchanged with dual leads terminating in the right atrium and right ventricle as before . The patient is status post median sternotomy . The cardiac silhouette is enlarged but stable . The mediastinal contours remain prominent with tortuosity of the thoracic aorta and calcification of the aortic knob , which is stable . Reticular nodular opacities predominantly in the lower lobes on the right greater than the left likely reflect chronic interstitial changes . There is no focal consolidation concerning for pneumonia , pleural effusion or pneumothorax on this single frontal view . No overt pulmonary edema is seen .
    OUTPUT:
    
1 . No acute cardiopulmonary process . 2 . Bibasilar reticular nodular opacities on the right greater than the left may be reflective of a chronic interstitial process . Further evaluation with high - resolution CT chest could be considered .