Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A pacemaker / ICD device appears unchanged . The heart is again moderately enlarged with a left ventricular configuration . The aorta is mildly tortuous . The cardiac , mediastinal and hilar contours appear unchanged . There is no definite pleural effusion . No pneumothorax is demonstrated . The lungs appear clear .
    OUTPUT:
    
No evidence of acute disease .