Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A dual - lead pacemaker / ICD device appears unchanged , with the leads again terminating in the right atrium and ventricle , respectively . The patient is status post median sternotomy . New mild right lateral pleural thickening suggests a small effusion with loculation . A more free flowing pleural effusion of small - to - moderate size is suspected on the left with thickening of the fissures . Streaky atelectasis is also seen within the lingula . There is no evidence for parenchymal edema . Thin anterior flowing osteophytes suggest skeletal hyperostosis . Mild degenerative changes are also present . The bones are probably demineralized to some extent .
    OUTPUT:
    
New left - sided pleural effusion ; and small , probably loculated pleural effusion on the right , which may be due to sequelae of a more remote prior effusion .