Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A left pectoral pacemaker with two leads terminating in the right atrium and right ventricle is unchanged . The patient is status post median sternotomy with multiple mediastinal surgical clips and wires appearing intact . Biapical pleural thickening is unchanged . A tiny nodule projecting at the left cardiophrenic angle may represent a vessel or a calcified granuloma . The lungs are otherwise clear without focal consolidation , pleural effusion or pneumothorax . No pulmonary vascular congestion or edema is present . The cardiac silhouette is normal in size . The mediastinal and hilar contours are stable with moderate tortuosity of the thoracic aorta and calcified aortic knob .
    OUTPUT:
    
No acute cardiopulmonary process .