Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Severe cardiomegaly is unchanged . Right chest wall AICD device is seen with leads in expected position of the right atrium and right ventricle . Lungs are mildly hyperinflated , without consolidation , pulmonary edema , pleural effusion or pneumothorax . Rugger ___ spine indicates renal osteodystrophy .
    OUTPUT:
    
Severe cardiomegaly , without evidence of pneumonia .