Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post tracheostomy . A dual - lead pacemaker / ICD device appears unchanged . Dialysis catheter again terminates at the cavoatrial junction . Cardiac , mediastinal and hilar contours appear unchanged . There is increased heterogeneous opacification predominantly involving the central parts of each lung . In addition , there are small pleural effusion suspected bilaterally .
    OUTPUT:
    
Increased heterogeneous pulmonary opacities ; differential considerations include fluid overload , pneumonia , aspiration , or combination .