Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable AP upright chest film ___ at 12 :41 is submitted .
    OUTPUT:
    
Marked thoracolumbar scoliosis . A left - sided dual lead pacer remains in place and the heart remains enlarged . A prosthetic aortic valve remains in place . On the current study , the retrocardiac area is obscured by the pacemaker and therefore can not be adequately evaluated . Lung volumes remain markedly low with crowding of the vasculature and no overt pulmonary edema . No pneumothorax is appreciated . There is interposition of the colon between the diaphragm and liver consistent with Chiladiti 's . Deformity of the body of the right scapula consistent with recent trauma and possible associated right - sided rib fracture , both of which were better assessed on the CT of the chest performed ___ .