Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is enlarged but unchanged from ___ . The mediastinal contours are within normal limits . A left - sided pacemaker with transvenous right atrial and left ventricular pacing wires as well as a right ventricular pacer / defibrillator lead follow their expected courses . There is no pneumothorax , pleural effusion or mediastinal widening . The pulmonary vasculature is distended but unchanged from the prior study . There is no frank pulmonary edema .
    OUTPUT:
    
1 . Cardiomegaly unchanged . 2 . Transvenous right atrial and left ventricular pacing wires as well as a right ventricular pacer / defibrillator follow expected courses . 3 . No pneumothorax