Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Single lead left - sided AICD is again seen , extending to the expected position of the right ventricle . The cardiac silhouette remains enlarged . The aortic knob is calcified . No focal consolidation , pleural effusion , evidence of pneumothorax is seen . There is no pulmonary edema . The lung apices are clear . There has been interval removal of a previously seen right - sided PICC .
    OUTPUT:
    
Persistent enlargement of the cardiac silhouette . Clear lung apices . No significant interval change .