Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided . Right IJ access dialysis catheter extends to the left of midline likely via left - sided SVC a with tip projecting over the region of the right atrium . In addition , a left chest wall AICD noted with lead following the course of the dialysis catheter to the left of midline likely via a left - sided SVC with the tip in the expected region of the right atrium . Midline sternotomy wires and mediastinal clips are noted . There is subtle consolidation in the right middle lobe which is concerning for pneumonia . Background emphysema is noted . A tiny right pleural effusion is present . Left lung is clear . No signs of edema . Heart size is mildly enlarged . Mediastinal contour is normal . No acute bony abnormality .
    OUTPUT:
    
1 . Right middle lobe pneumonia , small right pleural effusion , emphysema . 2 . Mild cardiomegaly . 3 . Dialysis catheter and AICD lead course into the right atrium by way of what appears to be a left - sided SVC . Please correlate clinically .