Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Dual lead pacemaker in situ with the lead tips in the appropriate positions . The cardiomediastinal contour is normal . No left - sided pneumothorax . Possible small left - sided pleural effusion . No airspace consolidation or suspicious pulmonary nodules or masses . Presumed surgical material in relation to the anteromedial aspect of the right hemidiaphragm ( ? Previous Morgagni hernia repair ) . Spondylotic changes of the cervical and thoracic spine . Degenerative changes of the shoulder girdles .
    OUTPUT:
    
Dual lead pacemaker in the appropriate position . No complications .