Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A dual - lead pacemaker / ICD device has leads terminating in the right atrium and ventricle , as before . The heart is at the upper limits of normal size . There is moderate unfolding of thoracic aorta with calcifications seen particularly along the arch . The mediastinal and hilar contours appear unchanged . Patchy opacity in the right middle lobe is not significantly changed and suggests scarring , predominantly in the right lower lobe . Hemidiaphragms appear flattened . Slight degenerative changes are similar along the thoracic spine .
    OUTPUT:
    
No evidence of acute disease .