Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left sided dual - chamber pacemaker device is noted with leads terminating in unchanged positions in the right atrium and right ventricle . The cardiac silhouette size is unchanged and mildly enlarged . Enlargement of the main pulmonary artery is stable . The pulmonary vascularity is not engorged . The lungs are clear . No pleural effusion or pneumothorax is detected . No acute osseous abnormalities are seen .
    OUTPUT:
    
No acute cardiopulmonary process .