Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A dual - lead pacemaker / ICD device appears unchanged with leads again terminating in the right atrium and ventricle , respectively . The heart is mildly enlarged . Allowing for low lung volumes , there is no definite change , however , although it is difficult to exclude a small pericardial effusion . There is no definite pleural effusion . Streaky basilar opacities suggest minor atelectasis . There is no pneumothorax . Flowing anterior osteophytes along the thoracic spine suggest hyperostosis .
    OUTPUT:
    
Patchy basilar opacities suggesting minor atelectasis in the setting of low lung volumes . No definite change in the size of the cardiac shadow allowing for differences in technique , although it is hard to exclude a small pericardial effusion .