Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post mitral valve replacement . A three - lead pacemaker / ICD device appears unchanged . The heart is similarly enlarged . The mediastinal and hilar contours appear unchanged , including a prominence of right hilar structures suggesting mild enlarged central pulmonary arteries . Vague opacification , particularly prominent in the mid and lower lungs , suggests mild vascular congestion . In addition , the left hemidiaphragm is obscured by retrocardiac opacity and a suspected pleural effusion . The retrocardiac opacity would be typical for atelectasis associated with a pleural effusion , but pneumonia is an additional consideration in the appropriate clinical setting .
    OUTPUT:
    
Findings suggesting mild pulmonary vascular congestion . Retrocardiac opacity , which is nonspecific etiology , but atelectasis associated with a pleural effusion could be considered , versus potentially pneumonia in the appropriate setting .