Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared to the study of 1 month prior there is no significant change . The left pectoral pacemaker with leads ending in the right atrium , right ventricle and coronary sinus is in unchanged position . Mild enlargement of the cardiac silhouette is stable . No focal consolidation , pleural effusion or pneumothorax . Surgical anchors in the right humeral head and clips in the right upper quadrant are unchanged .
    OUTPUT:
    
Stable appearance of the chest and pacemaker