Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The left - sided pacemaker with leads terminating in the right atrium and right ventricle also unchanged . There is a small right pleural effusion . Lungs are otherwise clear without focal consolidation or pneumothorax . Chain sutures in the right upper lung are unchanged . Cardiomediastinal silhouette is within normal limits . Multiple new right rib fractures without bony callus formation are identified . Remote fracture of a right inferior lateral rib is again seen .
    OUTPUT:
    
New small right pleural effusion , potentially hemothorax , in the setting of new right rib fractures . No focal consolidation .