Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac silhouette is moderately enlarged . The aorta is calcified . Dual lead left - sided pacemaker is stable in position . A right - sided VP shunt is partially seen coursing over the right hemi thorax and coiling in the right upper quadrant . The lungs are clear without focal consolidation . No pleural effusion or pneumothorax is seen .
    OUTPUT:
    
No acute cardiopulmonary process . Cardiomegaly again seen .