Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable AP upright chest radiograph ___ at 09 :49 is submitted .
    OUTPUT:
    
A single lead left - sided pacer remains in place . The heart remains enlarged with prominent mitral annular calcifications . Patchy opacity at the right base is not significantly changed favoring atelectasis in the setting of a chronically elevated right hemidiaphragm . However , there is increasing retrocardiac consolidation and likely an associated effusion , which although this could reflect atelectasis raises the possibility of pneumonia or aspiration . Clinical correlation is advised . In addition , the perihilar vasculature is more prominent suggesting a fluid replete state , no overt pulmonary edema is evident . Calcifications at the left apex are stable and may be pleural in etiology . No pneumothorax .