Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left chest wall dual lead pacing device is again noted . Low lung volumes are are seen with crowding of the bronchovascular markings . There is no edema or effusion . Cardiac enlargement is similar compared to prior . Degenerative changes of the shoulders is well as probable chronic posttraumatic changes of the proximal left humerus .
    OUTPUT:
    
No definite acute cardiopulmonary process .