Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP and lateral views of the chest ___ at 13 : 16 is submitted .
    OUTPUT:
    
Interval placement of a right - sided dual lead pacemaker with the leads terminating over the expected location of the right atrium and right ventricle , respectively . A left - sided Port - A - Cath is unchanged in position . There are severe degenerative changes of the right glenohumeral joint which are incompletely visualized . Overall cardiac and mediastinal contours are stably enlarged . An aortic valve replacement is again seen . Lung volumes remain low and there is worsening perihilar and interstitial edema . Small bilateral effusions . No pneumothorax .