Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post median sternotomy . A right - sided dual - lumen central venous catheter tip that terminates in the proximal right atrium , unchanged . Left - sided pacemaker device with leads terminating in the right atrium , right ventricle , and region of the coronary sinus is re - demonstrated . Moderate enlargement of cardiac silhouette is unchanged . The aorta is diffusely calcified and mildly tortuous . The mediastinal and hilar contours are otherwise unremarkable , and no pulmonary vascular congestion is present . Lungs remain hyperinflated with flattening of the diaphragms compatible with COPD . No focal consolidation or pneumothorax is present . Small bilateral pleural effusions are noted , possibly new in the interval . No acutely displaced fractures are visualized . The osseous structures are diffusely demineralized with moderate multilevel degenerative changes .
    OUTPUT:
    
Small bilateral pleural effusions . No pneumonia or pneumothorax .