Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A pacing device projects over the left chest with leads in the right atrium , right ventricle , and coronary sinus . Sternotomy wires are intact . The heart size is within normal limits . The mediastinal contours demonstrate calcified atherosclerotic disease of the aortic knob and a tortuous aorta , following the scoliotic curvature of the spine . A large hiatal hernia is present . The lungs show no lobar consolidation or collapse . There is no pulmonary edema or pleural effusion nor is there pneumothorax . Incidental note is made of osteopenia of the bilateral humeral heads .
    OUTPUT:
    
Hiatal hernia but no acute cardiopulmonary process .