Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Probable background hyperinflation / COPD . The patient is status post sternotomy . The cardiomediastinal silhouette is enlarged , but unchanged . Left - sided pacemaker / AICD type device is present , with lead tip unchanged . Multiple epicardial pacing wire is are present , similar to the prior film . There is upper zone redistribution , but no overt CHF . No focal infiltrate or effusion is identified . Minimal atelectasis versus slight thickening of the minor fissure is noted . Slight pleural thickening along lower chest walls bilaterally may relate to body habitus rather than frank pleural thickening . .
    OUTPUT:
    
1 . COPD and cardiomegaly , with AICD type device , similar to the prior film . 2 . There is upper zone redistribution , without other evidence of CHF .