Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is again markedly enlarged with a single - lead pacemaker device , whose lead again terminates over the expected region of the right ventricle . The cardiac , mediastinal and hilar contours appear stable including moderate tortuosity and calcification along the thoracic aorta . A small pleural effusion is probably new on the right with patchy right basilar opacity , probably due to atelectasis . The kyphotic curvature is mildly exaggerated with minimal loss in height among several lower thoracic vertebral bodies , but not likely to be acute .
    OUTPUT:
    
Suspected new small pleural effusion on the right with patchy minor atelectasis , although no definite parenchymal edema . Similar marked cardiomegaly .