Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left sided dual - chamber pacemaker is noted with leads again terminating in the right atrium and right ventricle . Moderate cardiomegaly persists . The aorta remains tortuous and diffusely calcified . Lung volumes are lower compared to the prior study . There is likely mild pulmonary vascular congestion . Retrocardiac opacification is present , with small bilateral pleural effusions , left greater than right noted . There is no pneumothorax . The lungs are hyperinflated with widening of the AP diameter suggestive of underlying COPD . Diffuse demineralization of the osseous structures with multiple remote rib fractures again noted .
    OUTPUT:
    
1 . Mild pulmonary vascular congestion with small bilateral pleural effusions . 2 . Retrocardiac opacification could reflect atelectasis but pneumonia is not excluded .