Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Dextropositioning appears similar to the prior examination . Lung volumes are low . The cardiac , mediastinal and hilar contours appear unchanged including moderate tortuosity of the aorta , a large epicardial fat pad , and substantial hiatal hernia . There is no definitive pleural effusion , but blunting of the right costophrenic sulcus suggests there may be a small effusion . Streaky basilar opacities are more prominent in the right lower lung than left , but not striking and compatible with atelectasis in the setting of low lung volumes , although early infection could be considered . There is no frank congestive heart failure .
    OUTPUT:
    
No definite congestive heart failure or pneumonia , but it is possible that there is a developing infection versus atelectasis at the right lung base , possibly with a very small pleural effusion . It may be helpful , when feasible clinically , to obtain standard PA and lateral radiographs with optimal inspiratory effort , or alternatively chest CT might be of value , if symptoms were to persist without clear etiology .