Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral views of the chest . Dual - lead chest wall pacer is seen with leads within the right atrium and right ventricular apex . Mitral valve replacement is again seen . Blunting of the left lateral costophrenic angles likely due to pericardial fat pad . The lungs are clear without focal consolidation , effusion or pneumothorax . The cardiac silhouette is enlarged but stable . Atherosclerotic calcifications again seen at the aortic arch . No acute osseous abnormality is identified .
    OUTPUT:
    
Cardiomegaly . No superimposed acute cardiopulmonary process .