Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest ___ at 10 :37 are submitted .
    OUTPUT:
    
A dual lead left - sided pacer is in place with the leads terminating over the expected location of the right atrium and right ventricle , respectively . The heart is mildly enlarged which most likely reflects cardiomegaly , although pericardial effusion can not be excluded . The lungs are hyperinflated suggesting underlying emphysema . Blunting of both posterior costophrenic angles likely reflects small effusions . No evidence of pulmonary edema . No pneumothorax .