Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post median sternotomy and CABG . Left - sided AICD / pacemaker device is noted with leads terminating in the region of the right atrium , right ventricle , and coronary sinus . Right - sided dual lumen central venous catheter tip terminates within the right atrium . The heart remains moderately enlarged . The mediastinal and hilar contours are unremarkable . There is no pulmonary vascular engorgement . Left lower lobe patchy opacity is concerning for infection or aspiration . A small left pleural effusion is re - demonstrated . There is no pneumothorax .
    OUTPUT:
    
Left lower lobe opacity concerning for pneumonia or aspiration . Small left pleural effusion .