Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Dual lead left pacemaker device appears intact and unchanged in position . Opacity projecting over the right mid hemi thorax is new . Another opacity projects over the region of the left lower mid hemi thorax . Retrocardiac opacity obscures part of the left heart border . These findings could be seen with an infectious process such as multifocal pneumonia . No pleural effusion or pneumothorax . Heart size is normal . Anterior wedging of a lower thoracic vertebral body is unchanged . Large to moderate hiatal hernia is unchanged .
    OUTPUT:
    
1 . Multifocal pneumonia . Follow - up radiograph after treatment to ensure resolution . If there is no complete resolution , a dedicated chest CT is recommended to exclude underlying lesion . 2 . Large hiatal hernia .