Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post sternotomy . A dual - lead pacemaker / ICD device with leads terminating in the right atrium and ventricle , appears unchanged . The heart is again mild - to - moderately enlarged . A diffuse mild interstitial abnormality is suggestive of mild vascular congestion , but more focal opacities in the upper lungs have improved . A hazy appearance of the left lung base suggests a persistent pleural effusion as was seen on the prior radiographs and CT , which may also explain elevation of the left hemidiaphragm . The effusion and associated opacity have increased .
    OUTPUT:
    
Increasing left basilar opacification with a suspected pleural effusion or opacity probably compatible with associated atelectasis ; although an infectious process is difficult to exclude , focal upper lung opacities have mostly resolved . Findings also suggest mild vascular congestion .