Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A dual - chamber left chest wall pacemaker is unchanged in position . Lung volumes are slightly low . There is no focal consolidation , pleural effusion or pneumothorax . The heart is stably enlarged . Median sternotomy wires are intact .
    OUTPUT:
    
No significant change since prior study and no acute cardiopulmonary process .