Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: On today 's exam , inspiratory volumes may be slightly low , but there is background hyperinflation . There is moderate cardiomegaly the pulmonary hila are grossly unchanged . There is slight upper zone redistribution similar to the prior film , without other evidence of CHF . On today 's film , the left hemidiaphragm is well defined and there is no increased opacity at the left base . Minimal blunting of the right costophrenic angle is consistent with a small pleural effusion . Incidental note is made of an incomplete azygos fissure . Again seen is a single E left - sided pacemaker with lead tip over the right ventricle .
    OUTPUT:
    
1 . Moderate cardiomegaly and upper zone redistribution , without other evidence of CHF . 2 . The left base is now seen to be clear , without significant collapse and without consolidation . 3 . Small right effusion . 4 . Pacemaker noted .