Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable AP upright chest radiograph was provided . A left chest wall AICD is noted with lead tips extending into the region of the right atrium and right ventricle . The heart remains moderately enlarged . There is a coronary stent projecting over the right heart border . There are small bilateral pleural effusions . Increased lower lung ground - glass opacities could represent pneumonia , less likely pulmonary edema given the distribution . Mediastinal contour is normal . Midline sternotomy clips and mediastinal clips are again noted . A left shoulder replacement is noted . Bony structures appear intact .
    OUTPUT:
    
Cardiomegaly with bilateral small effusions and lower lobe ground - glass opacities raise concern for pneumonia or atypical pulmonary edema .