Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is markedly enlarged , unchanged in size since the ___ examination . A left ICD device is unchanged in position and orientation . The central pulmonary vessels are mildly prominent . There is no pneumothorax , focal consolidation , or pleural effusion . There is no significant change since ___ .
    OUTPUT:
    
No acute process . Unchanged since the ___ examination .