Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A left - sided pacemaker device is noted with leads terminating in the right atrium and right ventricle . There is mild enlargement of cardiac silhouette , unchanged . Aortic knob calcifications are re- demonstrated . The pulmonary vasculature is normal , and the hilar contours are within normal limits . Known nodule in the lingula is better assessed on the prior CT . No focal consolidation , pleural effusion or pneumothorax is present . There are mild degenerative changes noted in the thoracic spine .
    OUTPUT:
    
No acute cardiopulmonary process .