Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left chest wall dual - lead pacing AICD device is again seen . A third lead of the presumed prior right chest wall device is redemonstrated . A dual - lumen central venous catheter tip is in the right atrium . Sternotomy wires are intact . The lungs are clear without consolidation . There is no effusion or pulmonary congestion . The cardiac silhouette is enlarged but unchanged in configuration . No acute osseous abnormality is detected .
    OUTPUT:
    
Cardiomegaly and small left pleural effusion . No pneumonia .