Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP upright and lateral views of the chest provided . Left chest wall pacer device with dual leads extending to the region the right atrium and right ventricle noted . There is cardiomegaly with mitral annular calcification noted . Opacity at the right apex likely scarring though in the absence of prior imaging , clinical correlation is advised . Background emphysema is noted . No large effusion . No convincing signs of pneumonia . Bony structures appear intact .
    OUTPUT:
    
Cardiomegaly . Right apical opacity may represent scarring though in the absence of prior imaging to establish stability , clinical correlation and if needed correlation with nonemergent CT is advised .