Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Overall stable radiographic appearance of the small - to - moderate left pleural effusion since ___ . Patient positioning with the chin flexed obscures complete visualization of the apices . No pulmonary edema , focal consolidation , pneumothorax . Stable appearance of the cardiomediastinal silhouette and hila . Median sternotomy wires appear intact and unchanged in position . The dual - lead cardiac device is also intact and unchanged , with 1 lead ending in the right atrium and the other in the right ventricle .
    OUTPUT:
    
Stable small - to - moderate left pleural effusion . No significant change since ___ .