Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right - sided pacemaker seen with intact leads in appropriate positions . Lungs well expanded and clear . There is no pleural effusion or pneumothorax . The cardiomediastinal silhouette is unremarkable . No evidence of acute fracture . Aorta is general large but not clearly aneurysmal .
    OUTPUT:
    
No acute cardiopulmonary process . No evidence of acute fracture . If suspicion for rib fracture persists , dedicated rib radiographs can be obtained .