Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A cardiac conduction device is contiguous with leads which appear to terminate in right ventricle and bilateral atria . Median sternotomy wires appear intact . Surgical ___ appear unchanged . Innumerable rounded pulmonary nodules are unchanged and consistent with metastatic disease . Assessment for a consolidation is limited by numerous metastases , however there appears to be a loss of the cardiac silhouette and increased opacity at the cardiac apex , concerning for pneumonia . Vertebral body heights are preserved .
    OUTPUT:
    
Assessment for pneumonia is somewhat limited given the patient 's widespread metastatic disease , however increased consolidation at the cardiac apex and loss of cardiac silhouette is concerning for pneumonia .