Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided dual - chamber pacemaker device is noted with leads terminating in the right atrium and right ventricle . Moderate enlargement of cardiac silhouette with left ventricular predominance is noted . The aorta is diffusely calcified . The mediastinal and hilar contours are within normal limits . The pulmonary vasculature is normal . No focal consolidation , pleural effusion or pneumothorax is identified . There are no acute osseous abnormalities . Multilevel degenerative changes are present within the thoracic spine .
    OUTPUT:
    
No acute cardiopulmonary abnormality .