Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral radiographs of the chest demonstrate well - expanded clear lungs . The cardiomediastinal and hilar contours are unchanged . No pneumothorax , pleural effusion , or consolidation . The right atrial lead has a different orientation on both the PA and lateral views as compared to the most recent prior radiograph , and is now more inferior and posterior . The right ventricular lead is in the normal position .
    OUTPUT:
    
The right atrial lead has a different orientation on both the PA and lateral views as compared to the most recent prior radiograph , and is now more inferior and posterior . Recommend echocardiogram for more additional localizing information regarding the position of this lead .