Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: 2 left - sided pacemaker is again seen with leads extending the expected positions of the right atrium and right ventricle . The cardiac silhouette remains enlarged . The aortic knob is calcified . There are relatively low lung volumes . Some patient motion is seen to the lower right hemi thorax . Blunting of the left costophrenic angle may be due to overlying soft tissues , but a trace pleural effusion is not excluded . No pneumothorax is seen .
    OUTPUT:
    
Slight blunting of the left costophrenic angle may be due to overlying soft tissue but a trace pleural effusion is not excluded .