Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are clear without consolidation , effusion , or edema . Cardiac silhouette is enlarged but stable . Left chest wall triple lead pacing device again noted . Median sternotomy wires are intact . There is leftward deviation of the trachea at the thoracic inlet raising the possibility of underlying right - sided thyroid enlargement . No acute osseous abnormalities .
    OUTPUT:
    
Cardiomegaly without acute cardiopulmonary process . Leftward deviation of the trachea at the thoracic inlet raising the possibility of underlying right - sided thyroid enlargement . Nonurgent thyroid ultrasound for further characterization is suggested .