Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is no focal consolidation , pleural effusion , or pneumothorax . The cardiac silhouette is top normal in size . A left chest AICD and leads are in unchanged positions . Median sternotomy wires and surgical clips are again noted projecting over the mediastinum .
    OUTPUT:
    
No acute cardiopulmonary process .