Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral images of the chest . A pacer is seen overlying the left anterior chest with intact leads in appropriate position . Median sternotomy wires and artificial valve are noted . The lungs are well expanded and clear . Tiny bilateral pleural effusions are noted . There is no pneumothorax . The cardiomediastinal silhouette has mildly increased to top normal in size . Old rib fractures are noted .
    OUTPUT:
    
Tiny bilateral pleural effusions . Otherwise unremarkable exam .