Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared to chest radiographs from ___ , right - sided pleural effusion has minimally improved . Left - sided pleural effusion , with fissural fluid , appears loculated and is unchanged . Lungs are hyperinflated with flattening of the bilateral hemidiaphragms , suggestive of emphysema . There is mild central vascular congestion without overt pulmonary edema . No focal consolidation . No pneumothorax . Cardiomediastinal silhouette is stable . Left pectoral cardiac pacing device with dual leads following their expected courses to the right atrium and ventricle , respectively .
    OUTPUT:
    
1 . Stable left pleural effusion appears loculated with fissural fluid . Minimally improved right pleural effusion . 2 . No pulmonary edema . No pneumonia . 3 . Hyperinflated lungs with flattening of bilateral hemidiaphragms , suggestive of emphysema . 4 . No radiographic findings suggestive of pulmonary embolism , though this exam alone can not confirm or exclude pulmonary embolism .