Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left chest wall dual lead pacing device is again noted . There is moderate cardiomegaly stable from prior . Median sternotomy wires and mediastinal clips are again seen . Lower lung volumes are noted on the frontal view with secondary crowding of the bronchovascular markings . There is no consolidation or effusion . No acute osseous abnormalities identified .
    OUTPUT:
    
Cardiomegaly without superimposed acute cardiopulmonary process .