Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided pacemaker device is re - demonstrated with single lead terminating in the region of the right ventricle . Moderate enlargement of the cardiac silhouette is re - demonstrated , and the mediastinal and hilar contours are unchanged . Diffuse atherosclerotic calcifications of the thoracic aorta again noted . The pulmonary vasculature remains mildly engorged , but appears chronic . Patchy opacity within the left lower lobe also appears long - standing , suggestive of atelectasis , but infection is not excluded . Lungs remain hyperinflated . No pleural effusion or pneumothorax is visualized with the right costophrenic angle excluded from the field of view on the frontal view . No acute osseous abnormality is detected . There are moderate multilevel degenerative changes seen in the thoracic spine .
    OUTPUT:
    
Patchy opacity in the left lower lobe could reflect an area of chronic atelectasis but infection can not be completely excluded . Unchanged moderate cardiomegaly with mild chronic pulmonary vascular congestion .