Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral chest views were obtained with patient in upright position . Analysis is performed in direct comparison with the next preceding similar study of ___ . Status post sternotomy , bypass surgery , permanent pacer with dual intracavitary electrode system is unchanged . Moderate widening and elongation of thoracic aorta with calcium deposits in the wall , as before . The overall heart size has increased slightly when comparing the frontal views . The lateral view again demonstrates some calcium deposits at the aortic valve area . These findings have not progressed markedly . Pulmonary vasculature does not demonstrate any acute vascular congestive pattern nor is there any evidence of acute interstitial or central alveolar edema . In comparison with the next previous study , the only sign of some increased chronic congestion is a very mild degree of blunting of the left lateral pleural sinus that did not exist on the previous examination . Right - sided pleuritic scar formation remains unchanged in appearance and there is no evidence of pneumothorax in the apical area . Nowhere in the lung fields is there any sign of a new pulmonary parenchymal pneumonic infiltrate .
    OUTPUT:
    
Mild progression of heart size and development of small left - sided pleural effusion but the examination does not show any findings that would match the clinical description of severe CHF . No acute pulmonary infiltrates of pneumonic appearance .