Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided dual - chamber pacemaker device is noted with leads terminating in unchanged positions in the right atrium and right ventricle . Cardiac , mediastinal and hilar contours are normal . Coronary artery stent is again seen . Pulmonary vasculature is not engorged . No focal consolidation , pleural effusion or pneumothorax is present . Right apical pleural thickening is unchanged . Remote right - sided rib fracture is again noted . No acute osseous abnormalities seen .
    OUTPUT:
    
No acute cardiopulmonary abnormality .