Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a dual - lead pacemaker / ICD device whose leads terminate in the right atrium and ventricle , respectively . The heart is normal in size . The main pulmonary artery contour is again enlarged . The mediastinal and hilar contours appear unchanged . The lungs appear clear . There is no pleural effusion or pneumothorax . Small osteophytes are similar along the thoracic spine .
    OUTPUT:
    
No evidence of acute disease . Similar convexity of the aortopulmonary window , most often seen with enlargement of the main pulmonary artery .