Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided . Dual pacemaker leads are seen , one terminating in the right atrium and another in the right ventricle . The right ventricular lead has an upward turn , and does not make the expected inferior courses toward the right ventricular apex . There is a small left effusion , and possible trace right effusion . There is mild pulmonary vascular congestion . Heart is mildly enlarged .
    OUTPUT:
    
Pacemaker leads in the right atrium and right ventricle , as described .