Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral views of the chest were obtained . A dual - lead left - sided pacemaker is seen with leads in the expected positions of the right atrium and right ventricle . The lungs remain hyperinflated with flattening of the diaphragms , suggesting chronic obstructive pulmonary disease . There appears to be blunting of the posterior costophrenic angles which may be related to COPD ; however , trace pleural effusions may be present . The cardiac silhouette is top normal . The aortic knob is calcified . Again , there may be mild vascular congestion , similar to prior .
    OUTPUT:
    
Possible mild vascular congestion , similar to prior . Slight blunting of the posterior costophrenic angles could relate to COPD , although trace pleural effusions are not excluded .