Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP upright and lateral views of the chest provided . Midline sternotomy wires noted . Right chest wall AICD is again noted with leads extending into the region of the right atrium and right ventricle . Abandoned left - sided leads are noted . There is opacity at the left mid and lower lung , slightly improved from prior though likely reflects persistent left effusion and basal atelectasis . Right lung is partially obscured by pacer device . Right lung appears grossly clear . Heart size can not be assessed . Mediastinal contour is unchanged . Bony structures are intact . Degenerative changes partially imaged at the shoulders .
    OUTPUT:
    
Persistent left mid and lower lung opacity which is concerning for atelectasis and pleural effusion . Minimal improvement compared with prior . No fracture .