Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable AP upright chest film ___ at 10 : 18 is submitted .
    OUTPUT:
    
Left - sided pacemaker remains in place with the leads unchanged in position . Overall cardiac and mediastinal contours are stable . The lungs remain well inflated without evidence of focal airspace consolidation to suggest pneumonia . There is likely a small layering left effusion which is not significantly changed . No pneumothorax is appreciated . No pulmonary edema .