Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided dual - lumen pacemaker device is noted with leads terminating in the right atrium and right ventricle . The heart size is normal with a left ventricular predominance . The aorta remains mildly tortuous and diffusely calcified . The pulmonary vascularity is normal . No focal consolidation , pleural effusion or pneumothorax is present . There are multilevel degenerative changes within the imaged thoracic spine . No displaced rib fractures are visualized .
    OUTPUT:
    
No acute cardiopulmonary abnormality . Specifically , no displaced rib fractures are present , but if there is continued clinical concern , a rib series can be obtained . No pneumothorax .