Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left chest wall dual lead pacing device is again seen . The lungs are clear of consolidation . Bilateral prominent extrapleural fat vs pleural thickening is seen bilaterally , unchanged . There is no consolidation , effusion or pulmonary edema . The cardiac silhouette is enlarged , similar compared to prior . Median sternotomy wires are again noted . No acute osseous abnormalities .
    OUTPUT:
    
No acute cardiopulmonary process .