Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated . There is a small left - sided pleural effusion , larger when compared to prior . Trace right pleural effusion is also noted . The lungs are clear of consolidation or edema . Moderate cardiomegaly is again noted . Atherosclerotic calcifications noted at the aortic arch . Left chest wall dual lead pacer again noted . Lower thoracic superior compression deformity is again seen .
    OUTPUT:
    
Trace right and small left pleural effusion , slightly larger when compared to prior . No focal consolidation .