Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest are obtained . A dual - lead pacer in unchanged position . The proximal lead appears to terminate in the right atrium and the distal lead appears to terminate at the level of the junction of the IVC with the right atrium . Please correlate clinically for positional adequacy . There is a large retrocardiac density containing an air - fluid level compatible with a known hiatal hernia . There is left basilar atelectasis and likely a tiny pleural effusion . Kyphotic deformity of the chest somewhat limits evaluation . Atherosclerotic calcifications along the thoracic aorta noted . Tracheobronchial tree calcifications are also noted . There is no definite sign of pneumonia or CHF . Bony structures appear diffusely demineralized .
    OUTPUT:
    
Hiatal hernia , tiny left pleural effusion and left basilar atelectasis . Stable position of dual - lead pacer though distal lead appears to terminate in the expected location of the IVC / right atrial jxn . Please correlate for positional adequacy .