Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A dual lead pacemaker / ICD device with leads terminating in the right atrium and ventricle , apparently via an anomalous left - sided superior vena cava , appears unchanged . The heart is again moderately enlarged . Patchy opacities about the heart suggest unchanged atelectasis or scarring in the adjacent lung parenchyma associated with cardiomegaly . The mediastinal and hilar contours appear similar . The aorta is tortuous and calcified . There is a slight upper zone redistribution of the pulmonary vascularity , but no overt congestive heart failure . There is patchy posterior basilar opacity , silhouetting the right hemidiaphragm suggesting a trace right - sided pleural effusion . There is no pneumothorax .
    OUTPUT:
    
1 . No overt evidence for cardiac failure although slight upper zone redistribution suggesting venous hypertension . 2 . Very small suspected right - sided pleural effusion with associated opacity , likely minor atelectasis .