Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest were provided demonstrating left chest wall pacer with leads extending to the region of the right atrium and right ventricle . Lower lung opacities are seen which could represent pneumonia . Bilateral small effusions are present . The heart appears enlarged , the overall mediastinal and hilar configuration is abnormal , though in this patient with paramediastinal fibrosis , the appearance may be stable . No pneumothorax .
    OUTPUT:
    
Lower lung opacities concerning for pneumonia . Please refer to subsequent CT for further details .