Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left chest wall dual lead pacing device is again seen the left atrial and left ventricular leads . There is a vague right mid lung opacity projecting over the anterior right fifth rib . Elsewhere the lungs are clear . There is no pneumothorax or effusion . The cardiomediastinal silhouette is within normal limits . Increased opacity projecting over the lower thoracic spine on the lateral view is due to significant lower thoracic / upper lumbar levoscoliosis and associated hypertrophic changes .
    OUTPUT:
    
No definite acute cardiopulmonary process . Vague opacity projecting over the right mid lung may be due to confluence of shadows and repeat exam with shallow obliques is suggested to ensure clearance .