Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A dual lead pacemaker / ICD device appears unchanged with leads again terminating in the right atrium and ventricle , respectively . The heart again appears mildly enlarged and the aorta again mildly tortuous . The cardiac , mediastinal and hilar contours appear stable . There is no pleural effusion or pneumothorax . The lungs appear clear .
    OUTPUT:
    
No evidence of acute cardiopulmonary disease .