Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable AP semi upright technique and low lung volumes exaggerate the already enlarged cardiac silhouette . Allowing for technique , cardiomediastinal contours appear grossly unchanged . Opacity of the left lung base is most consistent with a combination of moderate size pleural effusion and atelectasis , underlying consolidation not entirely excluded . The right lung is grossly clear . No pneumothorax . A pacemaker device is present . Extensive degenerative changes are seen in the right glenohumeral joint . The left glenohumeral joint is not well seen due to overlying pacemaker device .
    OUTPUT:
    
1 . Low lung volumes and AP technique exaggerate the already enlarged cardiac silhouette . Further evaluation for enlargement of the cardiac silhouette could be performed with PA technique and full inspiratory effort . Underlying pericardial effusion not excluded . 2 . Moderate size left pleural effusion with adjacent atelectasis , underlying consolidation not excluded . .