Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest are obtained . An AICD projects over the right chest wall with pacer lead extending into the right ventricle . Abandoned left chest wall pacer leads are present extending into the right heart . The lungs are hyperinflated reflecting known emphysema . Mild reticulation of the lung markings could suggest a component of mild fibrosis . There is blunting of the CP angles bilaterally likely indicative of bilateral pleural effusions . There are no definite signs of pneumonia or CHF . Cardiomediastinal silhouette appears grossly stable . Bony structures are intact . Midline sternotomy wires are also noted .
    OUTPUT:
    
Findings compatible with emphysema and possible underlying chronic lung disease / fibrosis . Small bilateral pleural effusions noted without definite signs of pneumonia .