Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post CABG and median sternotomy . Left - sided AICD device is noted with leads terminating in the right atrium , right ventricle , and coronary sinus , unchanged . Moderate cardiomegaly persists . The mediastinal and hilar contours are stable , with calcification of the thoracic aorta again demonstrated . Mild pulmonary vascular congestion persists . A small right pleural effusion persists , slightly decreased in size compared to prior chest radiograph . Right basilar atelectasis is noted . Subtle bilateral upper lobe nodular opacities which are better seen on the prior CT persist , and may reflect an infectious or inflammatory process . No new focal consolidation is identified . There are no acute osseous abnormalities .
    OUTPUT:
    
1 . Small right pleural effusion , slightly decreased from the prior chest radiograph . 2 . Mild pulmonary vascular engorgement . 3 . Subtle ill - defined nodular opacities in both upper lobes , better seen on the prior chest CT persist , and may reflect an infectious or inflammatory process .