Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A left - sided pacemaker remains in unchanged position , with leads terminating in the right atrium and right ventricle . As compared to prior chest radiograph , lung volumes are decreased . There is blunting of the left costophrenic angle which could reflect a small pleural effusion . Otherwise , no focal consolidation or pneumothorax is identified . The cardiac silhouette remains stable in size .
    OUTPUT:
    
Decreased lung volumes . Blunting of the left costophrenic angle is likely secondary to a small left - sided pleural effusion . No focal consolidation concerning for pneumonia .