Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided pacer device is noted with leads terminating in the right atrium and right ventricle as well as an epicardial lead projecting over the left heart border , unchanged . Moderate cardiomegaly is re - demonstrated . The mediastinal contours similar . Mild pulmonary vascular congestion is minimally improved from the prior study . Small left pleural effusion is similar compared to the prior study with left basilar opacity , potentially atelectasis but infection or aspiration is not excluded in the correct clinical setting . There is no pneumothorax . Multiple remote right - sided rib fractures are noted . Marked degenerative changes of the left glenohumeral joint
    OUTPUT:
    
Mild pulmonary vascular congestion , perhaps minimally improved , with small left pleural effusion and left basilar opacity which may reflect atelectasis , but infection or aspiration can not be excluded in the correct clinical setting .