Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Patient is status post median sternotomy with the superior most wire again appearing broken . Cardiac silhouette size appears normal , unchanged . Mediastinal contour is unchanged . Hilar prominence bilaterally reflects enlargement of the pulmonary arteries , as seen previously . There is no pulmonary edema . A moderate - sized left pleural effusion appears slightly increased compared to the previous radiograph with left basilar opacification likely reflective of compressive atelectasis . Small right pleural effusion appears similar with atelectasis / scarring noted in the right lung base . No pneumothorax is seen . Deformity of the right rib cage is unchanged . Marked degenerative changes are noted involving the left glenohumeral joint .
    OUTPUT:
    
1 . Moderate left pleural effusion , slightly increased in size compared to the previous study with left basilar opacification , likely compressive atelectasis . 2 . Trace right pleural effusion and right basilar atelectasis / scarring . 3 . Suggests underlying pulmonary arterial hypertension .