Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided dual - chamber pacemaker device is noted with leads terminating in the right atrium and right ventricle . The heart size is normal . The mediastinal and hilar contours are unchanged and within normal limits . The pulmonary vascularity is normal . Lungs are mildly hyperinflated . Redemonstrated is blunting of the left costophrenic sulcus , unchanged , and may reflect minimal pleural effusion or pleural thickening . No focal consolidation or pneumothorax is present . The pulmonary vascularity is not engorged . There are no acute osseous abnormalities .
    OUTPUT:
    
No acute cardiopulmonary abnormality . Chronic blunting of the left costophrenic sulcus , which could reflect a trace pleural effusion or pleural thickening .