Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Upright AP and lateral views of the chest were reviewed and compared to the prior study . A dual - chamber pacemaker is seen over the left hemithorax with leads extending into the right atrium and right ventricle . Median sternotomy wires and clips along the left mediastinal contour are likely from prior cardiac surgery . The lung fields are clear . Bilateral blunting of the costophrenic angles is unchanged since ___ and likely represents chronic small pleural effusions or pleural thickening . There is no pneumothorax or vascular congestion . The bones and soft tissues are unchanged .
    OUTPUT:
    
Dual - chamber cardiac pacemaker leads ending in the right atrium and right ventricle . No acute cardiopulmonary process .