Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided dual - chamber pacemaker device is noted with leads terminating in the right atrium and right ventricle , unchanged . Mild enlargement of the cardiac silhouette is similar . The aorta remains tortuous and diffusely calcified . Pulmonary vasculature is not engorged , and hilar contours are unchanged . Lungs are hyperinflated with emphysematous changes again noted in the upper lobes . Scarring in the lung apices is similar . No focal consolidation , pleural effusion or pneumothorax is detected . Clips are seen in the right upper quadrant of the abdomen . There are no acute osseous abnormalities .
    OUTPUT:
    
Emphysema . No acute cardiopulmonary abnormality .