Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiomediastinal and hilar contours are normal . Again noted is a left anterior wall dual - lead pacemaker defibrillator with tips terminating in the right atrium and right ventricle as expected . There is no pleural effusion or pneumothorax . The lungs are hyperinflated but clear . Slightly narrowed trachea appears stable .
    OUTPUT:
    
Slightly narrowed trachea , which may be due to suboptimal inspiration . Repeat chest radiograph at full end inspiration is recommended for further evaluation .