Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided dual chamber pacemaker device is re - demonstrated with leads in unchanged positions in the right atrium right ventricle . Cardiomegaly is similar . The aorta remains tortuous with atherosclerotic calcifications noted at the aortic arch . Mediastinal and hilar contours are unchanged . Pulmonary vasculature is not engorged . No focal consolidation , pleural effusion or pneumothorax is present . There are mild to moderate multilevel degenerative changes seen in the thoracic spine . Clips from prior cholecystectomy are demonstrated in the right upper quadrant of the abdomen . Remote fractures are re - demonstrated on the right .
    OUTPUT:
    
No acute cardiopulmonary abnormality .