Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post median sternotomy and CABG . Left - sided pacemaker device is noted with leads terminating in the right atrium and right ventricle . Heart size is mildly enlarged , with a left ventricular predominance , with dense mitral annular calcifications noted . Mediastinal and hilar contours are unchanged , with diffuse calcification of the aorta re - demonstrated . Enlargement of the main pulmonary artery is compatible with pulmonary arterial hypertension . Diffuse alveolar opacities are worse when compared to the previous exam , and likely reflect moderate pulmonary edema . Trace right pleural effusion is noted . No pneumothorax is identified . Dense mitral annular calcifications are seen . Multilevel degenerative changes are noted within the imaged spine as well as within both shoulders .
    OUTPUT:
    
Moderate pulmonary edema , worse when compared to the previous exam . Increased right pleural effusion .