Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided . Left chest wall pacer device is again noted with pacer leads extending into the region the right atrium and right ventricle . Midline sternotomy wires again noted . Patient is known to have extensive calcified pleural plaque likely accounting for the areas of hyperdensity projecting over the left lung . Since the prior exam , there is perhaps slight decrease in right pleural effusion . Otherwise , no significant change in the appearance of the chest . Cardiomediastinal silhouette is stable . Bony structures appear grossly intact .
    OUTPUT:
    
Extensive calcified pleural plaque accounts for opacities projecting over the left hemi thorax . Persistent though slightly decreased right effusion .