Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiomediastinal contours are stable with cardiomegaly and tortuous aorta . Pacer lead tips located in the right atrium and right ventricle . . The lungs are clear . There is no pneumothorax or pleural effusion . Right rib fractures and mild degenerative changes in the thoracic spine are again noted . There is a moderate hiatal hernia .
    OUTPUT:
    
No evidence of pneumothorax . Pacer leads in standard position