Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left pneumothorax is actually at the level of the third posterior interspace and extends laterally to the diaphragm , but that has changed very little since an initially appreciated on ___ , and there is no associated pleural effusion or atelectasis . Hyperinflation is due to emphysema . Heart size is normal . There is no focal pulmonary abnormality or pulmonary edema . The left subclavian right ventricular pacer lead is continuous from the left pectoral generator , unchanged in standard placement .
    OUTPUT:
    
Small to moderate left pneumothorax , , unchanged since ___ , no associated pleural effusion or atelectasis . Transvenous right ventricular pacer lead in standard placement unchanged . Emphysema .