Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Dual lead left - sided pacemaker is again seen with leads extending to the expected positions of the right atrium and right ventricle . No focal consolidation , pleural effusion or pneumothorax is seen . The cardiac and mediastinal silhouettes are unremarkable . Bilateral anterior costochondral calcifications are again noted . No overt pulmonary edema is seen .
    OUTPUT:
    
No acute cardiopulmonary process .