Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is moderate cardiomegaly . Left chest wall dual lead pacing device is seen with lead tips in the right ventricle and right atrium . The lungs are clear where not obscured by overlying pacer . There is no effusion or edema . Old healed right superior rib fractures are identified . No acute osseous abnormalities .
    OUTPUT:
    
Cardiomegaly without acute cardiopulmonary process .