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 right ventricle . Mild enlargement of cardiac silhouette is re - demonstrated . A moderate to large hiatal hernia is again noted . Pulmonary vasculature is normal . There is minimal atelectasis in the left lung base . No focal consolidation , pleural effusion or pneumothorax is identified . There is diffuse demineralization of the osseous structures . Moderate loss of height of a vertebral body at the thoracolumbar junction is unchanged .
    OUTPUT:
    
No acute cardiopulmonary abnormality . Moderate to large hiatal hernia .