Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Dual lead right - sided pacemaker is seen with lead extending the expected positions of the right atrium and right ventricle . Oblong radiopaque structure projects over the left lower hemi thorax which has the appearance of a pen and is most likely external to the patient . Correlate with direct visualization . No focal consolidation is seen . There is no pleural effusion or pneumothorax . The cardiac silhouette is top - normal to mildly enlarged . Mediastinal contours are stable .
    OUTPUT:
    
No acute cardiopulmonary process . Oblong radiopaque structure projects over the left lower hemi thorax which has the appearance of a pen and is most likely external to the patient . Correlate with direct visualization .