Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post sternotomy . A dual - lead pacemaker / ICD device is in place , with leads terminating in the right atrium and ventricle , as before . An aortic stent graft is partly visualized along the upper abdomen . The heart is normal in size . The mediastinal and hilar contours appear unchanged . Irregular pulmonary architecture is suggestive of emphysema . Scarring is similar at each lung apex including subpleural thickening . There is no evidence for pleural effusion or pneumothorax . No free air is demonstrated .
    OUTPUT:
    
No evidence of acute disease , including no evidence for free air .