Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left chest wall dual lead pacing device is seen in stable position . Median sternotomy wires and mediastinal clips are again noted . Cardiomediastinal silhouette is stable . The lungs are clear . No acute osseous abnormalities . Degenerative changes noted at the right acromioclavicular joint .
    OUTPUT:
    
No acute cardiopulmonary process .