Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A dual - lead pacemaker / ICD device appears unchanged , again with leads terminating in the right atrium and ventricle , respectively . The heart is moderately enlarged with a prominent main pulmonary artery contour . Central pulmonary arterial branches appear enlarged . The chest is hyperinflated . Mild background coarsening of lung markings is quite similar to the remote prior study , although there is mild new reticulation in the peripheral parts of lung zones at the bases , suggesting a mild coinciding interstitial abnormality . A bulla is more prominent at the right base . Patchy left basilar opacity suggests minor unchanged atelectasis . There is no definite pleural effusion or pneumothorax . The bones are probably demineralized .
    OUTPUT:
    
Findings suggest obstructive pulmonary disease with mild superimposed interstitial abnormality , suggesting mild superimposed vascular congestion .