Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left chest wall dual lead pacing device is again noted . The lungs are slightly hyperinflated . There is no focal consolidation or effusion . There is no pulmonary edema . Surgical clips project over the left mid lung and the left neck , similar to prior . No acute osseous abnormalities identified . Hypertrophic changes are noted in the spine .
    OUTPUT:
    
No acute cardiopulmonary process .