Elderly Man with Headaches and Weakness

A 71-year-old man presents with complaints of headaches and weakness that have been ongoing for almost a month. He denies any fever, nausea, or vomiting. He has noticed an occasional cough and denies any weight loss. The patient has an extensive history of coronary artery disease, hypertension, and hyperlipidemia. History is also significant for coronary artery bypass grafting. He denies any history of smoking. The man is afebrile, and the rest of his vital signs, including pulse oximetry, are within normal limits. Physical exam shows an elderly, ill-appearing man in no obvious distress. Breath sounds bilaterally are clear. You order a chest radiograph along with some bloodwork. The chest radiograph is shown. What is your impression?