Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: 2 lead left - sided pacemaker is seen with leads extending the expected positions of the right atrium and right ventricle . Again , there is elevation of the left hemidiaphragm with stomach and bowel beneath . The cardiac silhouette is somewhat shifted to the right , similar compared to ___ , likely secondary to the elevated left hemidiaphragm . Cardiac , mediastinal , and hilar contours are stable , in particular compared to ___ . No focal consolidation is seen . There is no large pleural effusion or pneumothorax .
    OUTPUT:
    
Dual lead left - sided pacemaker with leads extending the expected positions of the right atrium and right ventricle . No pneumothorax . Persistently elevated left hemidiaphragm . No acute cardiopulmonary process .