Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP upright and lateral views of the chest provided . Patient is tilted to his left . A dual - lead pacer is unchanged with lead tips extending into the right atrium and right ventricle . The heart remains mildly enlarged . Lung volumes are low without definite sign of pneumonia or CHF . Bony structures are grossly intact .
    OUTPUT:
    
Limited , negative .