Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral radiographs of the chest demonstrate normal heart size . The patient is status post median sternotomy with intact sternotomy wires . There is increased pulmonary vascularity with dilated pulmonary arteries and cephalization consistent with a history of congenital heart disease . No overt pulmonary edema . There is background intertitial abnormality with cuffing of the airways as can be seen with small airways disease , but there are more confluent retrocardiac and right infrahilar opacities which would reflect an early pneumonia . No pleural effusion or pneumothorax .
    OUTPUT:
    
1 . Background interstial abnormality with cuffing of the airways as can be seen with small airways disease with more confluent opacity in the bilateral lower lobes , which could represent early pneumonia . Correlation with prior films may be helpful . 2 . Increased pulmonary vascularity consistent with patients history of congential heart disease without overt edema . Telephone notification to Dr . ___ by Dr . ___ at 10 :00 on ___ and emailed to the ED QA nurse as the patient had already left the ED .