Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A left pectoral pacer and dual leads are new from the prior examination and appear in the expected position . Median sternotomy wires are stable . The heart is top - normal in size but stable from the prior examination . The hilar contours are within normal limits . There is a small right pleural effusion . No focal consolidation or pneumothorax is identified .
    OUTPUT:
    
New left chest pectoral wall pacer and dual leads in expected position . No evidence of pneumothorax . Small right pleural effusion .