Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A dual - lead pacemaker / ICD device , with leads terminating in the right atrium and ventricle , appears unchanged . The heart is mild to moderately enlarged . The mediastinal and hilar contours appear stable . The chest is hyperinflated . There is no pleural effusion or pneumothorax . The lungs appear clear . Bony structures are unremarkable . Surgical clips project over the right upper quadrant . There has been no definite change .
    OUTPUT:
    
No evidence of acute disease .