Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral views of the chest were obtained . The patient is status post median sternotomy . Triple - lead left - sided pacer device is again seen with leads in similar position as compared to the prior study . The cardiac silhouette is moderate to severely enlarged , which could be due to underlying pericardial effusion or cardiomyopathy . There is persistent left base opacity may be due to combination of pleural effusion and atelectasis . Trace right pleural effusion is also seen . There is mild - to - moderate pulmonary edema suggesting fluid overload . The aortic knob remains calcified . No evidence of pneumothorax is seen .
    OUTPUT:
    
Moderate - to - severe enlargement of the cardiac silhouette could be due to cardiomyopathy or pericardial effusion . Left base opacity , likely combination of pleural effusion and atelectasis , underlying consolidation difficult to exclude . Trace right pleural effusion . Vascular congestion / edema .