Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left chest wall dual lead pacing device is again seen . The lungs are clear of focal consolidation , effusion , or pulmonary edema . Cardiac silhouette is mildly enlarged . Median sternotomy wires and mediastinal clips are again noted . No acute osseous abnormalities identified .
    OUTPUT:
    
No acute cardiopulmonary process .