Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right - sided dual chamber pacemaker device is noted with leads within the right atrium and right ventricle . The heart remains moderately enlarged . The aorta is tortuous , unchanged , as are calcified right hilar lymph nodes . The lungs are clear and the pulmonary vascularity is normal . No pleural effusion or pneumothorax is identified . There are multilevel degenerative changes within the thoracic spine with dextroscoliosis of the thoracolumbar spine again noted . Extensive degenerative changes of the left glenohumeral joint are again visualized .
    OUTPUT:
    
No acute cardiopulmonary abnormality .