Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided pacer device is noted with leads again terminating in the right atrium right ventricle , unchanged . Low lung volumes persist with moderate enlargement of the cardiac silhouette appearing unchanged . Extensive atherosclerotic calcification the aortic knob . Mediastinal and hilar contours are similar . There is mild pulmonary vascular congestion , as seen previously . Small bilateral pleural effusions are without significant interval change . Patchy opacities are again seen in the lung bases . No new focal consolidation is evident .
    OUTPUT:
    
No substantial interval change from the prior study . Low lung volumes with mild pulmonary vascular congestion and small bilateral pleural effusions . Bibasilar patchy airspace opacities likely reflect atelectasis , but infection is difficult to exclude .