Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared to the prior study and allowing for differences in technique , I doubt significant interval change . On the lateral view , lead tips project anteriorly and posteriorly and could lie in relation to the right and left ventricles . Small amount of subcutaneous emphysema is noted about the battery pack , compatible with recent surgery . There is hyperinflation consistent with COPD . Changes along the right mediastinum are consistent with known neo esophagus . Rounded area of increased density in the lower middle mediastinum could also be related to the esophageal surgery . Prominence of the pulmonary hila could reflect pulmonary hypertension . There is deformity and pleural thickening along the right chest wall consistent with prior trauma and / or surgery . Multiple clips are seen posteriorly in the chest . There is blunting of both costophrenic angles posteriorly consistent with pleural fluid and / or thickening . No pneumothorax is detected .
    OUTPUT:
    
Leads extend over the right and left ventricles , respectively . Small bilateral effusions . No pneumothorax detected . Small amount of subcutaneous emphysema is noted about the battery pack compatible with recent surgery . Cardiomediastinal silhouette is enlarged but unchanged . No overt CHF . No focal consolidation .