Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided . Left chest wall pacer device is again seen with leads extending into the region of the right atrium , right ventricle and coronaries sinus . Midline sternotomy wires and prosthetic cardiac valve are again noted . The heart is top - normal in size . The mediastinal contour is normal . The lungs are clear without focal consolidation , large effusion or pneumothorax . No convincing signs of edema or congestion . Bony structures are intact . No free air below the right hemidiaphragm .
    OUTPUT:
    
No acute intrathoracic process . Top - normal heart size .