Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided dual - chamber pacemaker device is re - demonstrated with leads in the right atrium and right ventricle . Moderate cardiomegaly is again noted . Mediastinal and hilar contours are unchanged . Pulmonary vasculature is normal . Lungs are clear without focal consolidation . No pleural effusion or pneumothorax is detected . A right - sided VP shunt catheter is incompletely imaged . There are no acute osseous abnormalities .
    OUTPUT:
    
No acute cardiopulmonary abnormality .