Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post sternotomy and placement of a single - lead pacemaker device . The heart is mildly enlarged . There is a calcified aneurysm at the left ventricular apex . A patchy left basilar opacity is most suggestive of atelectasis that obscures the left hemidiaphragm . Widespread nodules are extensive in each lung , similar to the prior examination . A pleural effusion can not be excluded on the left due to overlying opacity , but none is identified on the right .
    OUTPUT:
    
Extensive metastatic disease . Mild cardiomegaly . Patchy left basilar opacity , although most likely atelectasis .