Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post mitral valve replacement . There is also a dual - lead pacemaker / ICD device with leads terminating in the right atrium and ventricle , respectively , as before . The heart is moderately enlarged . There are new vaguely defined but dense bilateral mid lung opacities which are worrisome for multifocal pneumonia , as well as a retrocardiac opacity . In addition , there is new elevation of the right hemidiaphragm with an increasing pleural effusion , probably of moderate size . Increasing streaky right basilar opacification with volume loss suggesting a component of associated atelectasis at the right lung base . There is no pneumothorax .
    OUTPUT:
    
New multifocal opacities worrisome for pneumonia . Increasing right - sided pleural effusion , likely of moderate size with suspected atelectasis .