Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A dual - lead pacemaker / ICD device has leads terminating in the right atrium and ventricle , respectively . The heart is normal in size . The mediastinal and hilar contours are stable . The chest is hyperinflated . A persistent meniscoid appearance to each posterior costophrenic sulcus may be related to pleural thickening although very small effusions are hard to exclude . The lungs appear clear . Mild degenerative changes are similar along the thoracic spine .
    OUTPUT:
    
No evidence of acute disease .