Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Patient is status post median sternotomy and mitral valve replacement . Right - sided dual - chamber pacemaker device is noted with leads terminating in the right atrium and right ventricle . Mild enlargement of the cardiac silhouette is unchanged . The mediastinal and hilar contours are similar with mild tortuosity of the thoracic aorta again noted . Pulmonary vasculature is not engorged . Lungs are clear . No pleural effusion or pneumothorax is seen . Clips are noted in the right upper quadrant of the abdomen compatible with prior cholecystectomy .
    OUTPUT:
    
No acute cardiopulmonary abnormality .