Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is moderately enlarged . A dual lead pacemaker is again visualized . There is pulmonary vascular redistribution and ill - defined vasculature predominantly on the right . There is volume loss in both lower lungs . there is obscuration of the right hemidiaphragm compatible with infiltrate / volume loss in this region . There is a small right effusion . There is a small left effusion . The patient is status post sternotomy with sternal wires and mediastinal clips .
    OUTPUT:
    
1 . CHF . 2 . An underlying infectious infiltrate , particularly in the right lower lobe can not be excluded .