Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right chest wall dual - lead pacing device is noted . The lungs are clear of confluent consolidation where not obscured by the pacing device and cardiac leads . There is a probable hiatal hernia . The cardiac silhouette is within normal limits for technique . Atherosclerotic calcifications noted at the aortic arch . The trachea is deviated to the left at the thoracic inlet , and there is increased soft tissue in the right paratracheal region .
    OUTPUT:
    
No definite acute cardiopulmonary process . Leftward deviation of the trachea at the thoracic inlet with increased right - sided soft tissue density . While this might all be due to right - sided thyroid enlargement given degree of the soft tissue abnormality , dedicated nonurgent chest CT is suggested to exclude underlying mass lesion - unless this area has been imaged already at another institution .