Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided dual chamber pacemaker device is noted with leads terminating in the right atrium and ventricle . Moderate enlargement of the cardiac silhouette is re - demonstrated , a component which may reflect a pericardial effusion . The mediastinal and hilar contours are similar . Pulmonary vasculature is not engorged . There is a continued moderate right pleural effusion , with trace left pleural effusion , not substantially changed in the interval . No pneumothorax is seen . Mild atelectasis is noted in lung bases . There are mild degenerative changes noted in the thoracic spine with slight loss of height of a vertebral body at the thoracolumbar junction , unchanged .
    OUTPUT:
    
1 . Moderate enlargement of the cardiac silhouette , not changed from the previous studies , a component which may reflect a moderate size pericardial effusion as seen on the previous CT . 2 . Moderate right and small left bilateral pleural effusions , similar to the previous exams .