Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lung volumes remain low . There is discoid atelectasis in the left lower lobe , but no focal consolidation . Right atrial and ventricular pacemaker leads course in expected position . Median sternotomy wires and mediastinal clips are present . Mild cardiomegaly and mild vascular congestion are new since ___ . Aorta is tortuous and calcified . Pacemaker attachment should not be mistaken for a small nodule in the right mid lung .
    OUTPUT:
    
Early cardiac decompensation .