Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided AICD / pacemaker device is noted with leads terminating in the regions of the right atrium and right ventricle . Epicardial leads are also seen terminating along the left heart border . Heart size remains mildly enlarged . The mediastinal and hilar contours are unchanged . Pulmonary vasculature is normal . No focal consolidation , pleural effusion or pneumothorax is identified . The lungs are hyperinflated with flattening of the diaphragms as before , suggestive of COPD .
    OUTPUT:
    
No acute cardiopulmonary abnormality .