Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided dual - chamber pacemaker device is again noted with leads terminating in the right atrium , right ventricle , and region of the coronary sinus . Heart size is normal . Mediastinal and hilar contours are unchanged with atherosclerotic calcifications again noted at the aortic knob . Lungs are hyperinflated but clear . No focal consolidation , pleural effusion or pneumothorax is present . Pulmonary vasculature is normal . No acute osseous abnormalities are visualized .
    OUTPUT:
    
No acute cardiopulmonary abnormality .