Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral views of the chest . Left chest wall dual - lead pacing device is again seen with leads in unchanged position . The lungs are clear without consolidation , effusion or pulmonary vascular congestion . The cardiac silhouette is mildly enlarged , somewhat less so than on previous exam . Tortuous descending thoracic aorta . There is no definite acute osseous abnormality identified . Old right - sided rib fractures are seen laterally .
    OUTPUT:
    
No acute cardiopulmonary process .