Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral views of the chest were obtained . Dual - lead left - sided AICD is again with leads seen in satisfactory position in the right atrium and right ventricle . The cardiac silhouette remains enlarged . The aorta is calcified and somewhat tortuous . Blunting of the right costophrenic angle raises concern for a trace right pleural effusion . There is also linear left base retrocardiac scarring / chronic atelectasis , similar to prior . Lungs are hyperinflated which may relate to COPD .
    OUTPUT:
    
Persistent enlargement of the cardiac silhouette . Trace blunting of the right costophrenic angle suggests a trace pleural effusion .