Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A left chest wall pacemaker is present leads in the lower right atrium and right ventricle . There is no focal consolidation , pleural effusion or pneumothorax . There is mild cardiomegaly . Degenerative changes are present within the right shoulder .
    OUTPUT:
    
Mild cardiomegaly without acute cardiopulmonary process .