Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: No change in the left - sided pacemaker with leads projecting to the right atrium and right ventricle . Mild to moderate cardiomegaly is unchanged . Calcified tortuous aorta is unchanged . Lungs are clear without focal consolidation , effusion , ___ pneumothorax . Thoracic spinal ankylosis is unchanged .
    OUTPUT:
    
Unchanged mild to moderate cardiomegaly , without other evidence of heart failure . No focal consolidation .