Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Patient is status post median sternotomy and cardiac valve replacement . Dual lead left - sided pacer device is seen with leads extending the expected positions of the right atrium and right ventricle . There may very slight blunting of the left costophrenic angle posteriorly , seen on the lateral view . No right pleural effusion is seen . There is no evidence of pneumothorax . Biapical , pleural thickening is seen . The cardiac and mediastinal silhouettes are unremarkable . Mild central pulmonary vascular engorgement is seen without overt pulmonary edema .
    OUTPUT:
    
Very slight blunting of the posterior left costophrenic angle could be due to a trace pleural effusion . Mild central pulmonary vascular engorgement without overt pulmonary edema . No focal consolidation to suggest pneumonia .