Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Median sternotomy wires are intact . There is a left pacemaker with leads terminating in the right atrium and right ventricle . Stable , mild cardiomegaly . Normal mediastinal and hilar contours . Focal opacification at the right base with silhouetting of the right heart border and right hemidiaphragm is concerning for small areas of pneumonia in the right middle and lower lobes . New , small right pleural effusion . Left lung is clear . No pneumothorax .
    OUTPUT:
    
New , small right pleural effusion with right middle and lower lobe pneumonia .