Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left chest wall pacemaker has leads in the right atrium and ventricle . There is no pleural effusion or pneumothorax . The lungs remain hyperexpanded with biapical hyperlucency , flattening of the diaphragm , and widening of the retrosternal clear space . The heart size is normal . Aorta is tortuous and calcified . There is no free air under the diaphragm .
    OUTPUT:
    
No acute process .