Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided dual - chamber pacemaker device is noted with leads terminating in the right atrium and right ventricle , unchanged . The heart size is normal . The mediastinal and hilar contours are unremarkable . Mild calcification of the aortic arch is again noted . The lungs are hyperinflated with attenuation of the pulmonary vascular markings towards the lung apices compatible with mild emphysema . Cluster of irregular small opacities in the right upper lung field are unchanged . No focal consolidation , pleural effusion or pneumothorax is present . The pulmonary vascularity is not engorged . There are no acute osseous abnormalities .
    OUTPUT:
    
No acute cardiopulmonary abnormality . Emphysema .