Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable upright chest radiograph ___ at 09 :22 is submitted .
    OUTPUT:
    
Dual lead right - sided pacer is unchanged . The heart remains enlarged . There are layering bilateral effusions with bibasilar patchy opacities suggestive of partial lower lobe atelectasis , although pneumonia or aspiration should also be considered . Interval improvement but residual mild to moderate pulmonary edema . No pneumothorax . Calcified mediastinal and hilar nodes as well as a calcified mass at the right apex consistent with prior granulomatous infection . Incidental note made of left shoulder hemiarthroplasty .