Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right chest wall pacer is again noted . Additional lead along the left lateral chest wall is similar compared to prior . The lungs are clear without consolidation , effusion , or edema . Cardiac silhouette is enlarged as on prior . No acute osseous abnormalities .
    OUTPUT:
    
Cardiomegaly without acute cardiopulmonary process .