Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A right pectoral pacemaker is in place with two leads terminating in the right atrium and right ventricle . The cardiac silhouette is mildly enlarged . The mediastinal contours are prominent , with unfolding of the thoracic aorta but the aortic knob remains distinct . The lungs are hyperinflated with flattening of the diaphragms and lucency at the lung apices , compatible with COPD . Small bilateral pleural effusions are present . There is improved pulmonary vascular congestion from the outside radiograph of ___ . No focal consolidation or pneumothorax is detected .
    OUTPUT:
    
1 . No mediastinal widening . 2 . Mild cardiomegaly . 3 . Small bilateral pleural effusions . Improved mild pulmonary vascular congestion from the outside radiograph of ___ .