Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post coronary artery bypass graft surgery . The heart is mild to moderately enlarged . There is prominent and indistinct central interstitium with prominent pulmonary vascularity suggesting mild - to - moderate vascular congestion . In addition , there is a moderate right - sided pleural effusion which has increased with associated opacity , which can probably be attributed to atelectasis , but underlying pneumonia is also a possibility . A trace left - sided pleural effusion is suspected . There is no pneumothorax . Moderate anterior osteophyte formation is noted along the mid - to - lower thoracic spine .
    OUTPUT:
    
1 . Similar mild - to - moderate pulmonary vascular congestion and cardiomegaly . 2 . Increasing small - to - moderate right - sided pleural effusion with associated parenchymal opacification and volume loss , possibly atelectasis , although an infectious cause is a possible consideration . 3 . Persistent nodular focus projecting over the right mid lung , likely nipple shadow . However , when clinically appropriate , evaluation with an additional PA view with nipple markers is suggested to evaluate further . Recommendation for follow - up PA view with nipple markers discussed with Dr . ___ by telephone on ___ at 6 pm .