Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided pacemaker device is noted with leads terminating in the right atrium and right ventricle . Severe enlargement of the cardiac silhouette is present , and the aorta is tortuous . The pulmonary vasculature is not engorged . No focal consolidation , pleural effusion or pneumothorax is clearly identified . No acute osseous abnormality is detected .
    OUTPUT:
    
Severe cardiomegaly . No radiographic evidence for pneumonia .