Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Biventricular pacemaker in situ with the lead tip seen in the right atrium , right ventricle and coronary sinus . Large left - sided effusion appears similar to slightly decreased in size compared to previous imaging . Mild thoracic scoliosis . No new areas of airspace consolidation . No suspicious pulmonary nodules or masses . Hyperinflation of the right lung . No right - sided effusion . Spondylotic changes of the thoracic spine .
    OUTPUT:
    
Left - sided pleural effusion appears similar to slightly decreased compared to previous imaging .