Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A pacemaker generator is seen overlying the right chest with 4 leads attached , 3 in unchanged position , 1 in the expected location the right atrium and 2 in the expected location of the right ventricle . The ___ lead is new , terminating in the position of the obtuse marginal coronary vein with the wire extending through the coronary sinus . Severe enlargement of the cardiomediastinal silhouette with the contour suggestive of an element of pericardial effusion is not significantly changed from ___ . The previous right pleural effusion and basilar opacity has resolved . There is no pneumothorax is present . Left lower lung opacities unchanged from ___ . Surgical clips overlie the left axilla .
    OUTPUT:
    
A new ___ pacemaker lead extends through the coronary sinus and terminates in the position of the obtuse marginal coronary vein with unchanged position of other 3 leads . No evidence of complication , particularly no pneumothorax .