Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided AICD / pacemaker device is noted with leads terminating in the right atrium and right ventricle . The heart size is top normal . The mediastinal contour is unremarkable . Severe enlargement of the pulmonary arteries bilaterally is compatible with pulmonary arterial hypertension . Lungs are hyperinflated with mild emphysematous changes again seen . Chronic interstitial abnormality is most pronounced within the periphery of the right upper and mid lung fields , slightly progressed compared to the prior radiograph . No focal consolidation , pleural effusion or pneumothorax is identified . There is no pulmonary edema . No acute osseous abnormalities are seen .
    OUTPUT:
    
No radiographic evidence for pneumonia . Mild emphysema with chronic interstitial abnormality most pronounced within the periphery of the right upper and mid lung fields . Pulmonary arterial hypertension .