Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Patient is status post median sternotomy . Left - sided pacer device is stable in position . There is a large pleural effusion with overlying atelectasis , again seen . Underlying consolidation is difficult to exclude . Small right pleural effusion is also present . No pneumothorax is seen . The cardiac silhouette appears mildly increase in size as compared to the prior study with mild to moderate cardiomegaly seen . Mediastinal contours are stable and unremarkable .
    OUTPUT:
    
Large left pleural effusion with overlying atelectasis , underlying consolidation difficult to exclude . Small right pleural effusion . Cardiomegaly , which may have increased slightly since the prior study .