Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated but clear without focal consolidation or large effusion . Cardiac silhouette is within normal limits . The thoracic aorta is somewhat tortuous with atherosclerotic calcifications at the arch . Of note , there is an unusual contour of the undersurface of the aortic arch with slightly medial lies atherosclerotic calcifications which do indeed raise possibility of dissection . Right chest wall dual lead pacing device is again seen .
    OUTPUT:
    
Abnormal contour to the region of the aortic arch with possibly medialized atherosclerotic calcifications . CTA is suggested to exclude the possibility of dissection - which had already been ordered .