Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Dual lead left - sided pacemaker is stable in position . The patient is status post cardiac valve replacement . Previous seen right mid lung opacity has improved in the interval however , there is increased opacity at the right lung base , particular the lateral right lung base . There is blunting of the bilateral costophrenic angles which may be due to post trace pleural effusions . The cardiac and mediastinal silhouette is grossly stable with the cardiac silhouette enlarged but possibly slightly less so as compared to the prior study . No pneumothorax is seen .
    OUTPUT:
    
Blunting of the bilateral costophrenic angles may be due to trace pleural effusions . Increased opacity at the lateral right lung base could be due to infection or aspiration in the appropriate clinical setting . Otherwise , lungs remain hyperinflated , suggesting chronic obstructive pulmonary disease . Persistent cardiomegaly .