Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Given rotation to the left , the lungs are clear . Cardiomediastinal silhouette is unchanged . There is no large effusion or vascular congestion . Left chest wall dual lead pacing device is again noted . No acute osseous abnormalities . Left shoulder arthroplasty is partially visualized on the lateral view .
    OUTPUT:
    
No acute cardiopulmonary process .