Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided dual - chamber pacemaker with leads terminating in the right atrium and right ventricle is in unchanged position . The patient is status post median sternotomy , with multiple clips again demonstrated in the neck . The heart size remains normal . The mediastinal and hilar contours are unremarkable . Pulmonary vascularity is normal . The lungs are clear without focal consolidation . No pleural effusion or pneumothorax is present . There are mild degenerative changes of the thoracic spine .
    OUTPUT:
    
No acute cardiopulmonary abnormality .