Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left chest wall dual lead pacemaker is present with the leads projecting over the right atrium and right ventricle . No focal consolidation , pleural effusion or pneumothorax identified . The size of the cardiac silhouette is enlarged but unchanged .
    OUTPUT:
    
No radiographic evidence of acute cardiopulmonary disease . Enlarged cardiac silhouette , unchanged .