Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral views of the chest were obtained . There are small bilateral pleural effusions with overlying atelectasis . The cardiac silhouette remains enlarged . The aorta is tortuous . Dual - lead left - sided pacemaker is again seen with leads unchanged in position . Evidence of DISH is seen along the spine .
    OUTPUT:
    
Small left pleural effusion , difficult to exclude trace right pleural effusion . Persistent cardiomegaly .