Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A single - lead pacemaker device is noted with lead terminating in the right ventricle . Interval removal of IJ , ET tube , and nasogastric tube . Bilateral moderate pleural effusions are noted with adjacent atelectasis which appear to be increased compared to the prior examination , however this may reflect the first true upright study that the patient has had . Cardiac silhouette can not be assessed in the presence of bilateral pleural effusions and should be followed with echo . There has been interval removal of the pericardial drain . No pneumothorax is identified .
    OUTPUT:
    
Bilateral moderate pleural effusions are noted with adjacent atelectasis which appear to be increased compared to the prior examination , however this may reflect first true upright study .