Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a single - lead pacemaker device terminating in the right ventricle , as before . The heart is again mild - to - moderately enlarged . There is no pleural effusion or pneumothorax . The lungs appear clear . Bony structures are unremarkable .
    OUTPUT:
    
Unchanged cardiomegaly . No evidence of acute cardiopulmonary disease .