Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided dual - chamber pacemaker with leads terminating in the right atrium and right ventricle are again noted , unchanged . The heart size is mildly enlarged . The aorta remains tortuous . Enlargement of the pulmonary arteries particularly on the right is unchanged , compatible with pulmonary arterial hypertension . Diffuse calcified pleural plaques are redemonstrated , compatible with the history of asbestos exposure . Pulmonary vascularity is not engorged . No new focal consolidation , pleural effusion or pneumothorax is present . There are no acute osseous abnormalities . Old bilateral rib fractures and remote trauma to the left shoulder are again seen .
    OUTPUT:
    
No acute cardiopulmonary abnormality . Bilateral calcified pleural plaques suggestive of prior asbestos exposure . Pulmonary arterial hypertension .