Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate right pleural effusion is unchanged . A right pectoral dual - lead cardiac pacemaker remains in place . The left lung is clear . There is no pneumothorax . Heart size can not be accurately assessed due to obscuration of the right heart border by pleural effusion . Multilevel spinal degenerative changes are stable .
    OUTPUT:
    
Unchanged moderate right pleural effusion .