Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Patient is rotated to the left . Within this limitation , the lungs are clear . Left chest wall dual lead pacing device is again noted . The cardiomediastinal silhouette is grossly unchanged . Anterior flowing osteophytes along the spine suggests DISH . Degenerative changes are seen at the shoulders bilaterally .
    OUTPUT:
    
No acute cardiopulmonary process .