Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Rotated positioning . A left - sided pacemaker present , with lead tips over right atrium right ventricle . An NG tube is present , tip extending beneath diaphragm , off film . Surgical ___ are noted over the upper abdomen in the midline . Linear density overlying the left lung could represent an epidural catheter , best correlated clinically . The patient is status post sternotomy . Note is made that the lower most sternotomy wire is fractured . There is probable mild cardiomegaly . There is increased retrocardiac density with a probable small left effusion and partial obscuration the left hemidiaphragm . There is minimal atelectasis in the right cardiophrenic region . No pneumothorax is detected . There is pleural parenchymal thickening / scarring at the left lung apex . The right first rib may be truncated , but is unchanged . Aside from right base atelectasis , the right lung is grossly clear . No gross right effusion , though minimal pleural fluid could be present on the right . Suspect background hyperinflation / COPD . Note made of old rib fractures seen in lower right chest , similar to ___ . Compared to ___ the heart size is larger . Left effusion and left lower lobe collapse and / or consolidation is new and right cardiophrenic atelectasis is more pronounced .
    OUTPUT:
    
1 . Small to moderate left effusion with underlying collapse and / or consolidation of the left base . 2 . Atelectasis in the right cardiophrenic region . 3 . Cardiac silhouette larger compared with ___ . 4 . Clinical correlation is required for full assessment . 5 . Fractured inferior sternotomy wire , unchanged compared with ___ .