Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left chest wall triple lead pacing device is again noted . The lungs are clear where not obscured on the left from the pacer . There is no effusion , consolidation nor edema . Moderate hiatal hernia is again noted . The cardiac silhouette is enlarged , similar compared to prior . No acute osseous abnormalities , right humeral head hardware is visualized .
    OUTPUT:
    
No acute cardiopulmonary process .