Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Dual - chamber pacemaker is present . The heart is enlarged , but no failure is identified . Atelectasis in the right middle lobe is present with probably also some volume loss in the right lower lobe with likely effusion . Nasogastric tube is present .
    OUTPUT:
    
Atelectasis in the right middle lobe and probably right lower lobe as well right effusion .