Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Dual lead pacemaker with the tips in the right atrium and right ventricle . No pneumothorax . No pleural effusions . Significant interval increase in the size of the thoracic aorta and increasing tortuosity when compared to ___ . No focal consolidation . The heart is mildly enlarged .
    OUTPUT:
    
Marked interval increase in the size of the ascending , arch and descending thoracic aorta with marked increasing tortuosity . This is concerning for underlying aortic aneurysm and if the patient has any clinical symptoms dissection . Stable appearance of the dual lead pacemaker in good position . Note chest radiograph can not assessment this pacemaker is safe for MRI .