Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided . Left chest wall pacer device is again seen with leads extending into the region the right atrium and right ventricle . Cardiomediastinal silhouette is unchanged with marked cardiomegaly again noted . Elevation of the right hemidiaphragm is again noted . There is no focal consolidation , large effusion or pneumothorax . No convincing evidence for edema . Bony structures are intact . No free air below the right hemidiaphragm is seen .
    OUTPUT:
    
Cardiomegaly unchanged . Stable elevated right hemidiaphragm . No convincing signs of pneumonia or edema .