Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is stable enlarged cardiac silhouette without signs of pulmonary edema or pulmonary vascular congestion . There is poor definition of one hemidiaphragm suggestive of pleural thickening or pleural effusion . The lungs are otherwise clear . There is no pneumothorax . Dual - lead pacer is again seen with lead terminating in expected position at the right ventricle .
    OUTPUT:
    
1 . Enlarged cardiac silhouette without signs of pulmonary edema or vascular congestion consistent with either cardiomyopathy or pericardial effusion . 2 . Poor definition of one hemidiaphragm suggestive of pleural thickening or pleural effusion .