Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A left - sided pacemaker is seen with 2 leads in unchanged position . Median sternotomy wires and vascular clips are seen consistent with prior cardiac surgery . The cardiomediastinal and hilar contours are remarkable for diffusely tortuous thoracic aorta and stable from the prior study . There is no evidence of focal consolidation , pleural effusion or pneumothorax identified .
    OUTPUT:
    
No acute cardiopulmonary abnormality . No significant change from the prior examination on ___ .