Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided dual - chamber pacemaker device is re - demonstrated with leads terminating in the right atrium and right ventricle , unchanged . Mild cardiomegaly is again noted . The cardiac and mediastinal contours are unchanged with a tortuous thoracic aorta again noted . Large hiatal hernia is re - demonstrated . There is no pulmonary vascular congestion . Linear opacity in the right mid lung field likely reflects subsegmental atelectasis . No focal consolidation or pneumothorax is present . Minimal blunting of the posterior costophrenic angles on the lateral view is relatively unchanged , and may reflect chronic pleural thickening or tiny amount of pleural fluid . No acute osseous abnormalities identified . Remote right rib fracture is again detected .
    OUTPUT:
    
No substantial interval change from prior . No focal consolidation to suggest pneumonia . Large hiatal hernia .