Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a dual - lead pacemaker / ICD device in similar position , with leads again terminating in the right atrium and ventricle , respectively . The heart is again mildly enlarged . There is mild unfolding of the thoracic aorta . The mediastinal and hilar contours appear unchanged . Patchy opacification of the medial right cardiophrenic angle appears unchanged and does not suggest an acute process ; it may reflect a epicardial fat pad . Streaky left basilar opacity suggests minor atelectasis or scarring . There is no pleural effusion or pneumothorax . Mild to moderate degenerative changes are similar along the thoracic spine .
    OUTPUT:
    
No evidence of acute disease .