Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP and lateral views of the chest . Left chest wall dual lead pacing device is seen unchanged in position . The lungs are clear . There is no effusion or pulmonary vascular congestion . The cardiomediastinal silhouette is unchanged and within normal limits . Median sternotomy wires and mediastinal clips again noted . No acute osseous abnormalities .
    OUTPUT:
    
No acute cardiopulmonary process .