Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are clear of focal consolidation or pneumothorax . There is a small left pleural effusion or pleural thickening . The heart continues to be enlarged , and there is a left cardiac pacer device is with leads terminating in appropriate position . The mediastinal contours are normal . Outpouching of the left hemidiaphragm may reflect a hiatal hernia or eventration which can be better assessed with a conventional PA radiograph .
    OUTPUT:
    
No pneumonia or pulmonary edema . Small left pleural effusion or pleural thickening .