Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left chest wall pacing device is again seen with leads in similar position . The lungs are clear without focal consolidation , effusion , or edema . Opacity at the right cardiophrenic angle is compatible with a prominent fat pad . Cardiac silhouette is enlarged but similar compared to prior . No acute osseous abnormalities .
    OUTPUT:
    
No acute cardiopulmonary process .