Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left chest wall dual lead pacing device is again noted . Median sternotomy wires and mediastinal clips are seen . The lungs are clear without focal consolidation , effusion , or edema . Degree of cardiomegaly is unchanged . No acute osseous abnormalities
    OUTPUT:
    
Cardiomegaly without acute cardiopulmonary process .