FINDINGS:
There is a dual lead right pectoral pacemaker with leads noted within the
 right atrium and ventricle, respectively.  Median sternotomy wires are well
 aligned.  Mild cardiomegaly and mild central pulmonary vascular congestion are
 noted. Low lung volumes results in crowding of the bronchovascular structures.
 Left lower lobe atelectasis and a probable small pleural effusion are seen,
 with superimposed infection difficult to exclude.  The upper lung fields are
 grossly clear.

IMPRESSION:
1.  Dense left lower lobe airspace opacity may represent effusion with
 atelectasis, although superimposed infection is difficult to exclude.
 2.  Mild cardiomegaly, mild central pulmonary vascular congestion, and
 probable small left pleural effusion.