Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest are provided . A dual - lead pacer is seen with its pacer pack overlying the left axilla and lead tips extending to the level of the right atrium and right ventricle . The heart is moderately enlarged . There is no evidence of pulmonary edema . However , in the right upper lobe , there is slight coarsening of the initial markings and mild distortion , which likely indicates the presence of focal area of scarring . No sizable effusion , though tiny effusions can not be excluded . Mild interstitial edema is difficult to exclude . Bony structures are intact .
    OUTPUT:
    
Moderate cardiomegaly without overt edema . Probable scarring in the right upper lung . Possible tiny effusions .