Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A single AP , supine chest radiograph was obtained . Pulmonary aeration has slightly improved since ___ . The lungs are hyperexpanded . Severe cardiomegaly , aortic tortuosity and extensive aortic calcification are unchanged . Dual chamber pacing leads from a right chest generator are in stable position . There is no pneumothorax or large effusion .
    OUTPUT:
    
Stable appearance of severe cardiomegaly and massive aortic tortuosity .