Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A three - lead pacemaker / ICD device appears unchanged . The cardiac , mediastinal , and hilar contours are stable . There is again a moderate - to - large left - sided pleural effusion with presumed parenchymal opacification , probably attributable to atelectasis . There is also a suspected small right - sided pleural effusion . There is no pneumothorax . Compared to earlier radiographs of the same day , hazy opacification and vascular prominence seem similar to mildly decreased .
    OUTPUT:
    
Findings suggesting moderate vascular congestion , but similar to improved . Moderate left - sided pleural effusion with balanced mass effect . This appearance could be seen with pleural effusion and coinciding atelectasis , although it is difficult to exclude aspiration as a potential cause for left basilar opacification .