Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared to the prior film , there is possible increased opacity at the left base , as the left hemidiaphragm is slightly less distinct . Inspiratory volumes are lower . Allowing for this , I doubt significant interval change . Again seen is a left - sided dual lead pacemaker , with lead tips over the right atrium and right ventricle . Only 1 of the pacemaker leads is well seen on the lateral view ; the other is obscured due to motion . Allowing for this , positioning appears nominal . Heart size , as before , is borderline , likely exaggerated by technique . No pneumothorax is detected . On the lateral view , the patient 's arm overlies the chest , limiting assessment for subtle infiltrate . Even so , the lowermost / posteriormost portion of the lower lobes are well seen . There is possible minimal blunting of the posterior costophrenic angles , but this portion of the lower lobes is otherwise clear . More anteriorly , assessment is limited by the overlying arm . Incidental note is made of ossification of the anterior longitudinal ligament ( DISH ) .
    OUTPUT:
    
1 . Dual lead pacemaker with lead tips in the right atrium and right ventricle . 2 . Probable atelectasis left lower lung , which may be slightly worse . Inspiratory volumes are noted to be slightly lower . 3 . Minimal blunting of posterior costophrenic angle ( s ) , but no other evidence of effusion .