Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A left pectoral pacemaker is again seen with dual leads terminating in the right atrium and right ventricle , as before . The inspiratory lung volumes are appropriate . The lungs are clear without focal consolidation concerning for pneumonia , pleural effusion or pneumothorax . The pulmonary vasculature is not engorged and there is no overt pulmonary edema . The cardiac silhouette remains mildly enlarged . The mediastinal and hilar contours are within normal limits with mild calcification of the aortic knob . Multiple surgical clips projecting in the right upper quadrant of the abdomen may be related to prior cholecystectomy . No acute osseous abnormality is detected .
    OUTPUT:
    
No acute cardiopulmonary process .