Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Patient is status post median sternotomy and placement of a left - sided pacer device with leads terminating in the right atrium and right ventricle , unchanged . Heart size remains mildly enlarged . Mediastinal and hilar contours are similar with tortuosity of the thoracic aorta again noted . Lungs are hyperinflated . Mild interstitial pulmonary edema is new in the interval , superimposed on a background of basilar predominant chronic interstitial lung disease . Small right pleural effusion is new . No pneumothorax is demonstrated . Widening of the left AC joint is unchanged , with chronic deformity of the distal clavicle compatible with prior trauma . Old right - sided rib fractures are also noted .
    OUTPUT:
    
Mild interstitial pulmonary edema superimposed on a background chronic interstitial lung disease . Small right pleural effusion .