Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable semi-upright radiograph of the chest demonstrates an enlarged cardiac silhouette , with sternotomy wires . Left - sided 2 lead pacemaker is present , with lead tips over right atrium and right ventricle . The pulmonary vasculature is indistinct . There is a right lower lobe opacity , not seen on prior examination , concerning for pneumonia in the appropriate clinical context . A small right pleural effusion may be present . Patchy opacity at the left base may represent atelectasis . Surgical clips are seen in the right upper abdomen immediately to the left of midline . .
    OUTPUT:
    
Findings consistent with CHF / edema . Right lower lobe opacity , of uncertain etiology or significance . The differential includes atelectasis in the setting of CHF . However , in the appropriate clinical context , it is concerning for pneumonia . This should be followed to assess for evolution / confirm resolution .