Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral chest radiographs were provided . The lungs are hyperinflated . A new left chest wall pacemaker is seen with leads in the right atrium and right ventricle . Multiple mediastinal clips are present . Median sternotomy wires are intact . The lungs are clear without focal consolidation , pleural effusion or pneumothorax . The heart size is normal . The bones are intact . There are mild degenerative changes in the thoracic spine .
    OUTPUT:
    
New pacemaker with leads in appropriate position . Hyperinflated lungs .