Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left dual - lead pacer is unchanged in appearance . Trace left greater than right pleural effusions are similar in appearance to the previous examination without evidence of pneumothorax . Changes of emphysema are noted . The heart is moderately enlarged with pericardial calcifications again seen . Rounded opacity projecting over the cardiac apex is likely due to pericardial calcficiations though a loculation of fluid or rounded atelectasis could have a similar appearance .
    OUTPUT:
    
Trace effusions without evidence of pneumothorax after thoracentesis .