Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Biventricular ICD noted over the left chest with leads properly projecting over the right ventricle , right atrium , and left ventricle . Sternotomy wires and surgical clips are unchanged . The heart is top normal in size . Opacification of the right lung seen previously , likely representing layering of pleural effusion is no longer seen in this upright radiograph . There is a small right - sided effusion seen better on the lateral radiograph . There is a new area of opacity at the right cardiophrenic angle , possibly representing an area of fluid or segmental atelectasis in the lower lobe . No pneumothorax .
    OUTPUT:
    
1 . Small right pleural effusion . 2 . Focal opacity at the right cardiophrenic angle likely represents an area of fluid or atelectasis in the medial basal segment of the right lower lobe . Suggest followup chest x-ray to better evaluate this region .